(0661) Impact of Metabolic Syndrome on Outcomes After Head and Neck Microvascular Reconstruction

Introduction: Metabolic syndrome (MetS) is a condition characterized by a series of metabolic dysfunctions leading to insulin resistance and atherosclerotic heart disease. There is a paucity of literature on the impact of MetS on outcomes after head and neck microvascular reconstruction (HNMVR). We studied a large, single surgeon population to examine if the presence of hypertension, diabetes mellitus (DM), and body mass index (BMI) over 25 synergistic effects on patient outcomes after HNMVR.

Methods: A retrospective chart review was performed on patients undergoing HNMVR by a single surgeon between 2010 to 2022. Patients with diagnosis of DM, hypertension, and BMI over 25 constituted the MetS cohort, while the remainder of the patient population constituted the non-MetS cohort. Additionally, the non-MetS group was divided into a control sub-cohort of patients with none of the 3 comorbidities. Outcomes were first compared between the MetS and non-MetS cohorts, and then between the MetS cohort and the control sub-cohort. Postoperative complications were compared between groups using a combination of student’s t-test, chi square test, and Fisher Exact Test.

Results: Among 926 eligible patients, 91 were in the MetS cohort, 835 in the non-MetS cohort, and 229 in the control sub-cohort. There were no differences (p > 0.05) between the MetS and non-MetS cohorts in terms of fistula formation, wound infection, need for reoperation, length of ICU stay, length of hospital stay, 30-day readmission, and 2-year survival. The MetS cohort had a greater incidence of fistula formation (p = 0.04) compared to the control sub-cohort, but there were no differences (p > 0.05) between the two groups for the remainder of the studied complications.

Conclusions: Our study showed within our single surgeon population, patients with diagnosed hypertension, DM, and BMI > 25 did not experience a significantly greater incidence of most postoperative complications after HNMVR compared to those without these comorbidities. We did find that fistula formation occurred at greater frequency in patients with hypertension, DM, and BMI > 25.