The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery
Microvascular flap surgery is a widely acknowledged procedure for significant defect reconstruction. Multiple flap complication risk factors have been identified, yet there are limited data on laboratory biomarkers for the prediction of flap loss. The controlling nutritional status (CONUT) score has...
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/14/4794 |
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| author | Rihards P. Rocans Janis Zarins Evita Bine Renars Deksnis Margarita Citovica Simona Donina Biruta Mamaja |
| author_facet | Rihards P. Rocans Janis Zarins Evita Bine Renars Deksnis Margarita Citovica Simona Donina Biruta Mamaja |
| author_sort | Rihards P. Rocans |
| collection | DOAJ |
| description | Microvascular flap surgery is a widely acknowledged procedure for significant defect reconstruction. Multiple flap complication risk factors have been identified, yet there are limited data on laboratory biomarkers for the prediction of flap loss. The controlling nutritional status (CONUT) score has demonstrated good postoperative outcome assessment ability in diverse surgical populations. We aim to assess the predictive value of the CONUT score for complications in microvascular flap surgery. This prospective cohort study includes 72 adult patients undergoing elective microvascular flap surgery. Preoperative blood draws for analysis of full blood count, total plasma cholesterol, and albumin concentrations were collected on the day of surgery before crystalloid infusion. Postoperative data on flap complications and duration of hospitalization were obtained. The overall complication rate was 15.2%. True flap loss with vascular compromise occurred in 5.6%. No differences in flap complications were found between different areas of reconstruction, anatomical flap types, or indications for surgery. Obesity was more common in patients with flap complications (<i>p</i> = 0.01). The CONUT score had an AUC of 0.813 (0.659–0.967, <i>p</i> = 0.012) for predicting complications other than true flap loss due to vascular compromise. A CONUT score > 2 was indicated as optimal during cut-off analysis (<i>p</i> = 0.022). Patients with flap complications had a longer duration of hospitalization (13.55, 10.99–16.11 vs. 25.38, 14.82–35.93; <i>p</i> = 0.004). Our findings indicate that the CONUT score has considerable predictive value in microvascular flap surgery. |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-11T00:57:50Z |
| publishDate | 2023-07-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7e826c599c9d4542804256710a9fe7992023-11-18T19:54:04ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011214479410.3390/jcm12144794The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive SurgeryRihards P. Rocans0Janis Zarins1Evita Bine2Renars Deksnis3Margarita Citovica4Simona Donina5Biruta Mamaja6Intensive Care Clinic, Riga East Clinical University Hospital, Hipokrata Street 2, LV-1079 Riga, LatviaDepartment of Hand and Plastic Surgery, Microsurgery Centre of Latvia, Brivibas Street 410, LV-1024 Riga, LatviaIntensive Care Clinic, Riga East Clinical University Hospital, Hipokrata Street 2, LV-1079 Riga, LatviaSurgical Oncology Clinic, Riga East Clinical University Hospital, Hipokrata Street 4, LV-1079 Riga, LatviaLaboratory Department, Riga East Clinical University Hospital, Hipokrata Street 2, LV-1079 Riga, LatviaInstitute of Microbiology and Virology, Riga Stradins University, Ratsupites Street 5, LV-1067 Riga, LatviaDepartment of Anaesthesia and Intensive Care, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, LatviaMicrovascular flap surgery is a widely acknowledged procedure for significant defect reconstruction. Multiple flap complication risk factors have been identified, yet there are limited data on laboratory biomarkers for the prediction of flap loss. The controlling nutritional status (CONUT) score has demonstrated good postoperative outcome assessment ability in diverse surgical populations. We aim to assess the predictive value of the CONUT score for complications in microvascular flap surgery. This prospective cohort study includes 72 adult patients undergoing elective microvascular flap surgery. Preoperative blood draws for analysis of full blood count, total plasma cholesterol, and albumin concentrations were collected on the day of surgery before crystalloid infusion. Postoperative data on flap complications and duration of hospitalization were obtained. The overall complication rate was 15.2%. True flap loss with vascular compromise occurred in 5.6%. No differences in flap complications were found between different areas of reconstruction, anatomical flap types, or indications for surgery. Obesity was more common in patients with flap complications (<i>p</i> = 0.01). The CONUT score had an AUC of 0.813 (0.659–0.967, <i>p</i> = 0.012) for predicting complications other than true flap loss due to vascular compromise. A CONUT score > 2 was indicated as optimal during cut-off analysis (<i>p</i> = 0.022). Patients with flap complications had a longer duration of hospitalization (13.55, 10.99–16.11 vs. 25.38, 14.82–35.93; <i>p</i> = 0.004). Our findings indicate that the CONUT score has considerable predictive value in microvascular flap surgery.https://www.mdpi.com/2077-0383/12/14/4794controlling nutritional statusmicrovascular flap complicationsreconstructive surgery |
| spellingShingle | Rihards P. Rocans Janis Zarins Evita Bine Renars Deksnis Margarita Citovica Simona Donina Biruta Mamaja The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery Journal of Clinical Medicine controlling nutritional status microvascular flap complications reconstructive surgery |
| title | The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery |
| title_full | The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery |
| title_fullStr | The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery |
| title_full_unstemmed | The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery |
| title_short | The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery |
| title_sort | controlling nutritional status conut score for prediction of microvascular flap complications in reconstructive surgery |
| topic | controlling nutritional status microvascular flap complications reconstructive surgery |
| url | https://www.mdpi.com/2077-0383/12/14/4794 |
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