The Association Between Race and Complications in Free Flap Surgery of the Head and Neck

TL;DR

This study found no significant difference in surgical outcomes for head and neck free flap surgeries based on race.

Contribution

The study uses propensity score matching to show race does not affect free flap surgery outcomes in head and neck reconstruction.

Findings

Caucasian patients were older and had different preoperative conditions compared to non-Caucasian patients.

After matching, no significant differences in length of stay, readmission, or reoperation were found between races.

Race does not appear to impact surgical outcomes for head and neck free flap reconstruction.

Abstract

Objective

The objective of this study was to assess the impact of race on outcomes in patients undergoing free flap reconstruction of the head and neck.

Methods

Data were taken from the National Surgical Quality Improvement Program (NSQIP) database for surgical procedures relating to free flap reconstruction of the head and neck using appropriate Current Procedural Terminology (CPT) codes from 2017 to 2019. Outcomes were initially compared by race. A sub-analysis was performed after propensity score matching between those who identified as Caucasian (White) and Black or African American in race.

Results

In total, 1589 patients underwent head and neck free flap surgeries between 2017 and 2019. Of those, 1075 patients identified as Caucasian and 176 identified as non-Caucasian, with 94 identifying as Black or African American. Prior to propensity score matching, Caucasian patients were significantly older, more likely to have moderate dyspnea, more likely to be partially functionally dependent, and less likely to require a ventilator preoperatively than non-Caucasian patients. There were no significant differences in length of stay, readmission, and reoperation between patients identifying as Caucasian and patients identifying as Black or African American.

Conclusion

For patients included in the NSQIP database, race does not appear to impact outcomes in those undergoing free flap reconstruction of the head and neck.