{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:57:14Z","timestamp":1780599434074,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR00224504"],"award-info":[{"award-number":["KL2TR00224504"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["K23 DE038010"],"award-info":[{"award-number":["K23 DE038010"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Commonly used predictive models for postoperative pulmonary complications (PPCs) do not perform when applied to head and neck cases. A head and neck\u2010specific risk prediction tool is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on 794 free flap head and neck surgery cases at a single center were abstracted from the electronic medical record. Each case was reviewed for the development of PPCs. A predictive model was developed and was then compared to existing predictive models for PPCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The least absolute shrinkage and selection operator procedure identified age, alcohol use, history of congestive heart failure, preoperative packed cell volume, preoperative oxygen saturation, and preoperative metabolic equivalents as predictors of PPCs in the head and neck population. The model demonstrated an area under the receiving operating characteristic curve of 0.75 (0.69\u20130.80) with moderately good calibration. Comparisons to the performance of existing models demonstrate superior performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The model for the development of PPCs developed in this article displays superior performance to existing models.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26689","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T14:45:22Z","timestamp":1617115522000},"page":"2178-2184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["An improved predictive model for postoperative pulmonary complications after free flap reconstructions in the head and neck"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6323-8700","authenticated-orcid":false,"given":"Derek K.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery and Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Freundlich","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Biomedical Informatics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin R.","family":"Shinn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Burton","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Rohde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"McEvoy","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2013.10.012"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200008000-00015"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318293065c"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181fc6e0a"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.08.007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)01082-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2015.10.004"},{"key":"e_1_2_8_9_1","first-page":"CD011151","article-title":"Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury","volume":"12","author":"Guay J","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31821b5839"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h3646"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.3.744"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2016.05.007"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000334"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0466"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-10-200111200-00005"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-019-1435-x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.123083"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2016.4065"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188167"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2007.05.001"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23228"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2002"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1475-x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen401"},{"issue":"17","key":"e_1_2_8_26_1","first-page":"e418","article-title":"ACC\/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery","volume":"116","author":"Fleisher LA","year":"2007","journal-title":"Circulation"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010359"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002591"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000007363"},{"issue":"8","key":"e_1_2_8_30_1","first-page":"e9898","article-title":"Development and feasibility of a prehabilitation protocol for patients diagnosed with head and neck cancer","volume":"12","author":"Boright L","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-016-3379-8"},{"key":"e_1_2_8_32_1","first-page":"CD008343","article-title":"Perioperative alcohol cessation intervention for postoperative complications","volume":"11","author":"Egholm JW","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.02.105"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.moo.0000130573.25903.b3"}],"container-title":["Head &amp; 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