{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:05:44Z","timestamp":1789553144382,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Early recovery after major head-and-neck reconstruction is not determined by flap survival alone. This exploratory study examined whether preoperative frailty-inflammatory phenotypes are associated with delayed swallowing recovery, persistent nutritional dependence, and poorer quality of life at 12 weeks. Methods: In a prospective single-center cohort study, 84 adults undergoing major head-and-neck oncologic reconstruction were assigned to three clinically defined phenotypes: low-risk (n = 28), intermediate (n = 29), and combined frailty-inflammatory (n = 27). Twelve-week outcomes included the Functional Oral Intake Scale (FOIS), MDADI, EORTC global health, PEG dependence, and a composite poor-recovery endpoint. Because of the small sample size, all estimates are reported to two significant figures, and every analysis is regarded as hypothesis-generating. Results: Compared with the low-risk group, the combined phenotype was older (63 \u00b1 9 vs. 55 \u00b1 9 years) and had a higher mFI-5 (3.2 \u00b1 0.6 vs. 1.0 \u00b1 0.7) and CRP\/albumin ratio (2.2 \u00b1 0.6 vs. 0.6 \u00b1 0.2; all p &lt; 0.001). At 12 weeks the combined phenotype showed greater weight loss (12 \u00b1 2%), lower FOIS (3.2 \u00b1 1.3), lower MDADI (51 \u00b1 7), and PEG dependence in 52% (all p \u2264 0.002). A higher mFI-5 was associated with poor recovery (adjusted OR 2.1 per point; 95% CI 1.0\u20134.1; p = 0.04), an estimate whose confidence interval is wide and imprecise. Conclusions: In this small cohort a frailty-inflammatory framework was associated with clinically meaningful heterogeneity in early recovery. The findings are preliminary and require prospective, adequately powered, multicenter validation before any clinical use.<\/jats:p>","DOI":"10.3390\/jcm15187134","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:15:04Z","timestamp":1789395304000},"page":"7134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Frailty-Inflammation Phenotypes and Early Functional and Patient-Reported Recovery After Head-and-Neck Oncologic Reconstruction: An Exploratory Prospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Sonia Roxana","family":"Burtic","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Discipline of Medical Communications, Department II Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Research Center for Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Bogdan Florin","family":"Capastraru","sequence":"additional","affiliation":[{"name":"Department XV, Disciplina Ortopedie-Traumatologie I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5714-6877","authenticated-orcid":false,"given":"Panche","family":"Taskov","sequence":"additional","affiliation":[{"name":"Discipline of Plastic and Reconstructive Surgery, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-9340","authenticated-orcid":false,"given":"Tudorel","family":"Mihoc","sequence":"additional","affiliation":[{"name":"Department X, General Surgery II, Discipline of Surgical Emergencies, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Codrina Mihaela","family":"Levai","sequence":"additional","affiliation":[{"name":"Discipline of Medical Communications, Department II Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Research Center for Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4581-8487","authenticated-orcid":false,"given":"Andreea Mihaela","family":"Kis","sequence":"additional","affiliation":[{"name":"Department I\u2014Management and Communication, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0776-0809","authenticated-orcid":false,"given":"Roxana Manuela","family":"Fericean","sequence":"additional","affiliation":[{"name":"Discipline of Dermatology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Mihaela-Iuliana Ciortan","family":"Ciortan (Sirbu)","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Otorhinolaryngology (ENT) Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel-Laurentiu","family":"Pop","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Discipline of Medical Communications, Department II Microscopic Morphology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Adelina Maria","family":"Jianu","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamaoto.2016.2981","article-title":"Optimal Perioperative Care in Major Head and Neck Cancer Surgery with Free Flap Reconstruction: A Consensus Review and Recommendations from the Enhanced Recovery After Surgery Society","volume":"143","author":"Dort","year":"2017","journal-title":"JAMA Otolaryngol. 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