000			03589nam a22005537a 4500
008			191204s20202020 xxu||||| |||| 00| 0 eng d
022			_a0738-1085
024			_a10.1002/micr.30530 [doi]
040			_aOvid MEDLINE(R)
099			_a31739379
245			_aThrombocytosis is associated with complications after microvascular surgery: An NSQIP data analysis.
251			_aMicrosurgery. 40(3):288-297, 2020 Mar.
252			_aMicrosurgery. 40(3):288-297, 2020 Mar.
252			_zMicrosurgery. 2019 Nov 18
253			_aMicrosurgery
260			_c2020
260			_fFY2020
265			_saheadofprint
265			_sppublish
266			_d2019-12-04
268			_aMicrosurgery. 2019 Nov 18
520			_aBACKGROUND: Complications after microvascular surgery, such as partial flap loss, and arterial/venous compromise cannot only increase morbidity for the patient but also tax the healthcare system. Thrombocytosis, both essential and reactive, can predispose patients to thrombosis and hemorrhage and thus should intuitively have an effect on the outcome of microvascular free tissue transfers. We sought to evaluate the effect of preoperative thrombocytosis on outcomes after microvascular free flap surgery.
520			_aCONCLUSION: Patients with thrombocytosis undergoing microvascular free flaps are at increased risk for complications, including the need for a blood transfusion, prolonged hospital stays, and reoperation. Copyright (c) 2019 Wiley Periodicals, Inc.
520			_aMETHODS: A retrospective review of the 2013-2016 American Collges of Surgeons, National Surgical Quality Improvement Program (ACS NSQIP) database identified 4,299 patients who had microsurgical flaps. Of these 3,744 had preoperative platelet levels recorded. Fifty-four patients had preoperative thrombocytosis, defined as a platelet count >450 K/CUMM, while 3,690 did not. The groups were compared; demographics, comorbidities, and smoking status were recorded. We then examined outcomes between groups including average operative time, length of hospital stay, need for transfusion, deep vein thrombosis (DVT) postoperatively, and need for reoperation.
520			_aRESULTS: When comparing the two cohorts, there was no statistical difference in comorbidities. We found a significant difference between the thrombocytosis and control cohort in need for transfusion (29.6 vs. 12.8%, p = .0002), average days till discharge (8.36 vs. 5.75, p = .009), and need for reoperation (27.8 vs. 13.8%, p = .003). There was no difference in DVT occurrence (0 vs. 0.1%, p = .46) or average operation time (535 m vs. 482 min, p = .088).
546			_aEnglish
650			_a*Microsurgery
650			_a*Postoperative Complications/ep [Epidemiology]
650			_a*Postoperative Complications/et [Etiology]
650			_a*Thrombocytosis/co [Complications]
650			_a*Vascular Surgical Procedures/mt [Methods]
650			_aAdult
650			_aData Analysis
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPostoperative Complications/pc [Prevention & Control]
650			_aQuality Improvement
650			_aRetrospective Studies
650			_aTreatment Outcome
650			_aUnited States
651			_aMedstar Franklin Square Medical Center
657			_aJournal Article
700			_aDel Corral, Gabriel A
790			_aCorral GD, Herrera FA, Inglesby D, Tapp M, Tarabishy SP
856			_uhttps://dx.doi.org/10.1002/micr.30530 _zhttps://dx.doi.org/10.1002/micr.30530
942			_cART _dArticle
999			_c4767 _d4767