Viewing abstract #1461

Association between Pulmonary Embolism Rates and BMI Greater than 25 in Patients Undergoing Free Flap Reconstruction of the Head and Neck Region

Rakan Saadoun, MD; Fuat Baris Bengur, MD; Elizabeth A. Moroni MD; Justin Beiriger BSE; Yusuf Surucu, MD; Mark Kubik, MD; MD; Shaum Sridharan, MD; Mario G. Solari, MD
University of Pittsburgh
2022-01-13

Presenter: Rakan Saadoun

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.

Director Name: Mario G. Solari

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

PURPOSE: Pulmonary embolism (PE) is a life-threatening complication seen in less than 6% of patients after free tissue transfer to the head and neck (H&N) region. Fixed-dose enoxaparin 30 mg twice daily (BID) is a widely used chemoprophylaxis. Nonetheless, differences in enoxaparin metabolism based on body weight can influence the sufficiency of this regime.
We aim to assess the impact of body-mass-index on the PE rates within 30 days of surgery.

METHODS: The population included in this retrospective cohort study are patients who underwent H&N reconstruction with free tissue transfer. All patients received enoxaparin 30 mg BID prophylactically. Patients with renal insufficiency were excluded. The cohort was divided into patients with BMI less than 25 (group A) and patients with BMI more than 25 (group B). PE within 30 days of surgery was retrospectively recorded. Statistical analysis was performed using chi-square and binary logistic regression.

RESULTS: 676 patients were included. The mean BMI was 26.698.35. PE rates among all patients were 2.7%. PE rates in group A (n=319) were significantly lower than B (n=357) (1.3% vs. 3.9%, p= 0.031). After counting for Caprini score, BMI more than 25 was independently associated with almost three times increased PE risk (OR, 3.12; 95%CI,1.004-9.697)

CONCLUSIONS: PE rates are significantly higher in group B even after counting for the Caprini score, which may indicate insufficient anticoagulation in this group.