{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:54:58Z","timestamp":1790888098063,"version":"4.1.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T00:00:00Z","timestamp":1407974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine whether blood transfusions are associated with adverse outcomes in patients with head and neck cancer (HNC) undergoing microvascular free tissue transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of all patients who underwent free flaps for reconstruction after HNC resection from July 2007 through February 2013 at a single institution were reviewed. Rates of overall survival (OS), recurrence free survival (RFS), and postoperative wound infection were determined. Statistical analyses included Cox proportional hazards models and chi\u2010square tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 167 patients, 90 received 0 to 2 units of blood and 77 received\u2009\u2265\u20093. After controlling for age, preoperative hemoglobin, preoperative albumin, cancer stage, and adverse pathologic features, transfusion of\u2009\u2265\u20093 (versus 0 to 2) units was associated with poorer OS (<jats:italic>P<\/jats:italic>\u2009=\u20090.0006; hazard ratio [HR]\u2009=\u20092.96) and RFS (<jats:italic>P<\/jats:italic>\u2009=\u20090.003; HR\u2009=\u20092.35). The rates of wound infection in patients who received 0, 1, 2, or\u2009\u2265\u20093 units were 13.3%, 21.2%, 33.3%, and 31.2%, respectively. There was a statistically significant difference in wound infection rates between those patients receiving 0 to 1 versus\u2009\u2265\u20092 units (<jats:italic>P<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients who receive\u2009\u2265\u20093 units of blood after free tissue transfer for HNC had a significantly increased risk of death after controlling for age, preoperative hemoglobin and albumin, cancer stage, and adverse pathologic features. Increased transfusions are also associated with higher wound infection rates. The increased tendency to transfuse free flap patients in order to maintain a threshold hematocrit may have a detrimental impact on survival and wound infections and should be revisited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b. <jats:italic>Laryngoscope<\/jats:italic>, 125:86\u201391, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24847","type":"journal-article","created":{"date-parts":[[2014,8,14]],"date-time":"2014-08-14T08:14:42Z","timestamp":1408004082000},"page":"86-91","source":"Crossref","is-referenced-by-count":52,"title":["Impact of blood transfusions on patients with head and neck cancer undergoing free tissue transfer"],"prefix":"10.1002","volume":"125","author":[{"given":"Deepa","family":"Danan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Smolkin","sequence":"additional","affiliation":[{"name":"University of Virginia School of Public Health Sciences University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikole E.","family":"Varhegyi","sequence":"additional","affiliation":[{"name":"University of Virginia School of Public Health Sciences University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen R.","family":"Bakos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Jameson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"David C.","family":"Shonka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Health System Charlottesville Virginia U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,8,14]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"253","article-title":"Effect of blood transfusions on subsequent kidney transplants","volume":"5","author":"Opelz G","year":"1973","journal-title":"Transplant Proc"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpaic.2009.01.017"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.5.1180"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)90673-5"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24132"},{"key":"e_1_2_7_8_1","unstructured":"University of Virginia Blood Band and Transfusion Medicine Service Handbook.http:\/\/www.healthsystem.virginia.edu\/pub\/medlabs\/lab\u2010handbook\u2010test\u2010directory\/labgeneral\/labspecific\/bloodbank.html. Accessed on March 19 2013."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10313"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000127600"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.11.024"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24847","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T18:43:42Z","timestamp":1696358622000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,14]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1002\/lary.24847"],"URL":"https:\/\/doi.org\/10.1002\/lary.24847","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,14]]}}}