Association of Systemic Inflammatory Markers With Complications in Free Flap Reconstruction: A Retrospective Cohort Study.

Abstract

The association between preoperative systemic inflammatory markers and postoperative free flap complications remains insufficiently defined, particularly in trauma-related reconstructions. The aim of our study was to investigate the association between systemic inflammatory markers and postoperative complications of free flaps used in soft tissue reconstruction. This was a retrospective cohort study. The main independent variables were systemic inflammatory markers such as neutrophil, lymphocyte, monocyte, platelet, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic inflammatory response index (SIRI), and systemic immune inflammatory index (SII). The relationship between complications and inflammatory markers was analyzed. Cut-off values, sensitivity, and specificity of the associated markers were determined. The study consisted of 55 patients, 40 (72.7%) were men and 15 (27.3%) were women. Their average age was 33.63 years with a standard deviation of 15.34 years. The cumulative complication rate was 40% (22 patients). In the group with complications, NLR, PLR, and SII values were significantly higher (p-values were 0.008, 0.002, and 0.002, respectively). Cut-off values with the sensitivity and specificity were NLR > 2.68 (63.6% sensitivity, 84.8% specificity), PLR > 148.64 (81.8% sensitivity, 57.5% specificity), SII > 656.91 (72.7% sensitivity, 78.7% specificity). The inflammatory indices NLR, PLR, SII were found to be associated with postoperative complications and demonstrated specific cut-off values; however, these findings should be interpreted as associative rather than predictive.