Background and purpose: Free flap has become the main way of reconstruction after surgery for head and neck tumor. Vascular crisis is easy to cause skin flap necrosis

and hypercoagulability is the main cause of vascular crisis. This study explored the factors influencing postoperat

ive hypercoagulability of free flap reconstruction for head and neck tumor

and provided reference for the prevention and treatment of hypercoagulability. Methods: A retrospective analysis was conducted according to the medical records of 243 patients admitted to Department of Otolaryngology

Second Affiliated Hospital of Fujian Medical University from Apr. 2017 to Jul. 2020 who underwent free flap reconstruction for head and neck tumor. The patients were divided into the hypercoagulable group and the non-hypercoagulable group according to whether postoperative hypercoagulable state occurred

and the incidence of postoperative hypercoagulable state and related influencing factors were statistically analyzed. Results: Among the 243 patients

128 patients had postoperative hypercoagulability

and the incidence was 52.7% (128/243)

including 73.4% (94/128) of two postoperative coagulation abnormalities

21.1% (27/128) of three abnormalities and 5.5% (7/128) of four abnormalities. Results of single factor analysis showed that gender

age

alcoholism

diabetes

tumor stage

surgical repair

intraoperative blood loss

intraoperative blood transfusion

operative time

postoperative leukocyte

postoperative triglyceride

postoperative high-density lipoprotein and postoperative Ca

2+

were the possible influencing factors of postoperative hypercoagulability (all P0.05). Multivariate factor logistic regression analysis showed that diabetes mellitus (OR=1.823

95% CI: 1.246-4.719)

tumor stage (OR=2.155

95% CI: 1.126-4.126)

postoperative leukocyte (OR=1.346

95% CI: 1.068-2.979) and postoperative triglyceride (OR=3.583

95% CI: 1.539-8.343) were independent risk factors of postoperative hypercoagulability. Conclusion: Postoperative hypercoagulability of free flap reconstruction for head and neck tumor is more common. For patients with risk factors of diabetes

advanced tumor stage

postoperative high leukocyte and high triglyceride

comprehensive intervention measures should be taken actively.