IDENTIFYING HIGH-RISK PATIENTS BEFORE HEAD AND NECK ONCOLOGIC SURGERY

Patients from the Comprehensive Cancer Center of the Arthur G. James C ancer Hospital and Research Institute, Ohio State University, Columbus , who were undergoing major head and neck oncologic surgery were prosp ectively studied to determine predictors of postoperative medical comp lications and wound infection. of 119 patients studied, 28 (24%) had a t least one postoperative medical complication. The strongest predicto rs of medical complication were poor functional capacity as assessed b y the Specific Activity Scale questionnaire and alcohol abuse. Thirtee n patients (11%) developed wound infections. The strongest predictors of wound infection were an elevated preoperative platelet count and pr olonged surgery. Wound infection was the strongest correlate of prolon ged hospital stay. These findings suggest that the Specific Activity S cale questionnaire identifies patients at risk for medical complicatio n, that alcohol abuse should be managed aggressively, and that thrombo cytosis identifies patients at risk for wound infection.