Association between hypertension requiring medication and 30-day outcomes in head and neck microvascular surgery

Philip R. Brauer, Patrick J. Byrne, Brandon L. Prendes, Jamie A. Ku, Peter J. Ciolek, Xuefei Jia, Eric D. Lamarre

Research output: Contribution to journalArticlepeer-review


Background: Hypertension has been shown to be both a protective factor and a risk factor for complications in head and neck reconstructive surgery. Methods: Retrospective analysis of microvascular free tissue transfer patients using the National Surgical Quality Improvement Program database. Results: Hypertensive patients (n = 1598; 46.9%) had a significantly higher rate of complications, including pneumonia (p < 0.001), myocardial infarction (p = 0.003), and intra/post-operative transfusion (p < 0.001). In a multivariable model, hypertension was associated with returning to the operating room (OR = 1.45 [95% CI 1.20, 1.76], p < 0.001), post-operative medical complications (OR = 1.53 [95% CI 1.24, 1.90], p < 0.001), and surgical complications (OR = 1.17 [95% CI 1.00, 1.37], p = 0.047). However, no difference in 30-day readmission was found (p > 0.05). Conclusions: Hypertension is a modifiable risk factor for post-operative complications in head and neck free tissue transfer, in which prospective studies are required to establish causation. This study may serve as an impetus for proactive recommendations to manage hypertension before undergoing head and neck microvascular surgery.

Original languageEnglish (US)
Pages (from-to)168-176
Number of pages9
JournalHead and Neck
Issue number1
StatePublished - Jan 2022
Externally publishedYes


  • free flap
  • head and neck surgery
  • otolaryngology
  • patient safety
  • reconstruction

ASJC Scopus subject areas

  • Otorhinolaryngology


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