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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Alcohol Drinking, Body Mass Index, Cohort Studies, Coronary Artery Disease, Diabetes Complications, Female, Follow-Up Studies, Free Tissue Flaps, Graft Survival, Head and Neck Neoplasms, Humans, Hypertension, Male, Malnutrition, Middle Aged, Nutritional Status, Peripheral Vascular Diseases, Prealbumin, Proportional Hazards Models, Pulmonary Embolism, Reconstructive Surgical Procedures, Retrospective Studies, Risk Factors, Smoking, Treatment Outcome, Venous Thrombosis.
user
Is low prealbumin level a risk factor for microvascular free flap failure? Context: The purposes of this study were 1) to estimate and compare the 1-month survival rates of patients with acute malnutrition (low prealbumin level) and patients who are not malnourished (normal prealbumin level) and 2) to identify risk factors associated with microvascular free flap failure. To address the research purposes, we designed a retrospective cohort study and enrolled a sample composed of patients who underwent head and neck microvascular reconstruction and had prealbumin levels measured in the perioperative period. The primary predictor variable was nutritional status (low vs normal prealbumin level). The primary outcome variable was flap survival. One-month survival rates were estimated by use of Kaplan-Meier survival analyses. Risk factors for free flap failure were identified by use of multivariate marginal Cox proportional hazards modeling. The sample was composed of 162 patients who underwent microvascular free tissue transfer during the study enrollment period. The 1-month survival estimates for patients who were and were not malnourished were 76.5% (95% confidence interval [CI], 48.8% to 90.5%) and 95.2% (95% CI, 90.1% to 97.7%), respectively (P = .002). In the adjusted Cox hazards proportions model, acute malnutrition was associated with a 4-fold increased risk of failure (P = .04) in comparison with those patients with a normal nutritional status.
assistant
Acute malnutrition in patients undergoing microvascular free flap reconstruction in the head and neck region was associated with an increased risk for free flap failure. Final Decision: yes