Factors influencing postoperative hypercoagulability of free flap reconstruction for head and neck tumor

Background and purpose: Free flap has become the main way of reconstruction after surgery for head and neck tumor. Vascular crisis is easy to cause skin flap necrosis, and hypercoagulability is the main cause of vascular crisis. This study explored the factors influencing postoperative hypercoagulability of free flap reconstruction for head and neck tumor, and provided reference for the prevention and treatment of hypercoagulability. Methods: A retrospective analysis was conducted according to the medical records of 243 patients admitted to Department of Otolaryngology, Second Affiliated Hospital of Fujian Medical University from Apr. 2017 to Jul. 2020 who underwent free flap reconstruction for head and neck tumor. The patients were divided into the hypercoagulable group and the non-hypercoagulable group according to whether postoperative hypercoagulable state occurred, and the incidence of postoperative hypercoagulable state and related influencing factors were statistically analyzed. Results: Among the 243 patients, 128 patients had postoperative hypercoagulability, and the incidence was 52.7% (128/243), including 73.4% (94/128) of two postoperative coagulation abnormalities, 21.1% (27/128) of three abnormalities and 5.5% (7/128) of four abnormalities. Results of single factor analysis showed that gender, age, alcoholism, diabetes, tumor stage, surgical repair, intraoperative blood loss, intraoperative blood transfusion, operative time, postoperative leukocyte, postoperative triglyceride, postoperative high-density lipoprotein and postoperative Ca 2+ were the possible influencing factors of postoperative hypercoagulability (all P