Thrombocytosis Predicts Surgical Site Infection in Head and Neck Microvascular Surgery- A Pilot Study

Objective/Hypothesis: Early and objective prediction of complications in head and neck reconstructive surgery could decrease morbidity and prolonged hospital stays but unfortunately most complications are not identified until their effect is fully realized. There are limited data regarding the association of platelet levels and post-operative complications. Post-operative thrombocytosis (POTCT) is proposed as a possible indicator for complications following free-flap reconstruction. Study Design: Retrospective review. Methods: A multisite retrospective chart review of patients undergoing free tissue transfer between 2013 and 2018 was undertaken. POTCT was recorded and data normalized between institutions. Data were compared between groups using t-tests and logistic regression (P <.05). A lag-1 difference was used to compare the rate of change in platelet values. Results: A total of 398 patients were included. POTCT and a rate of change of 30 K between POD5 and POD6 was significantly associated with the presence of post-operative complication (P =.007). Additionally, lag-1 difference demonstrated a significant association of change in daily platelet counts and complication rates. Conclusions: Isolated POTCT may be an early predictor of complications in HNC patients undergoing free-flap reconstruction. Level of Evidence: 4 Laryngoscope, 131:1542–1547, 2021.