The total amount of fluid administered is associated with postoperative complications in head and neck cancer surgery

ObjectivePatients with head and neck cancer often undergo extensive ablative and reconstructive surgery. Many risk factors are unalterable, but some operative variables are possible to adjust. The goal of this study was to estimate the association between operative variables and the incidence of perioperative complications in a contemporary tertiary care university-based head and neck patient population and a Veteran Administration hospital head and neck patient population from an earlier time period.MethodsWe retrospectively reviewed all patients who underwent major head and neck surgery.ResultsTwo-hundred-two university patients and 122 veteran patients were reviewed. On multivariable analysis, the total amount of intravenous (IV) fluid received during the procedure was associated with postoperative complications as were patients' weight, American Society of Anesthesiologists (ASA) score, and adult comorbidity evaluation-27 (ACE-27) score. These associations did not depend on whether the patient was treated at the university or veteran hospital.ConclusionOur study suggests that the odds of a postoperative complication increase as the total amount of IV fluid increases. Significant findings of the study: Our results demonstrate an association between increased risk of complications with lower weight and increased intraoperative fluid administration, ASA score, and ACE-27 score. What this study adds: Our study showed a reliable predictor of postoperative complications despite changing practices over time or the patient population makeup is the total volume of fluid administered, which is one of the few modifiable risk factors to minimize complications in head and neck cancer patients.