Sangal et al identified risk factors for unplanned reoperation in a patient who has had major head and neck surgery. These can help to identify a patient who may require more aggressive management. The authors are from Rutgers New Jersey Medical School.

Patient selection: status post major head and neck surgery for cancer (glossectomy, mandibulectomy, laryngectomy, pharyngectomy)

Risk factors for unplanned reoperation:

(1) Black race (odds ratio 1.72)

(2) disseminated cancer (odds ratio 1.85)

(3) greater total operation time (odds ratio 2.05; > 50th percentile)

(4) superficial surgical site infection (odds ratio 2.56)

(5) deep surgical site infection (odds ratio 4.83)

(6) wound dehiscence (odds ratio 8.36)

(7) ventilator dependence for more than 48 hours after surgery (odds ratio 2.95)

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