Outcomes of free flap reconstruction in the elderly
Bibliographic record
Abstract
BACKGROUND: The reconstructive surgeon is often faced with the dilemma of offering free flap reconstruction to the elderly after surgical extirpation in the head and neck due to the perception that this population tolerates these procedures poorly. METHODS: A 42-month retrospective review of all microvascular free flap reconstruction cases from a large head and neck oncology program was reviewed. A series of 278 patients met inclusion criteria and were stratified into 2 age groups: 45 to 64.9 years (n = 177) and ≥65 years (n = 101). RESULTS: There was no significant difference in primary outcomes, anastomotic compromise (p = .36), unsalvageable flaps (p = .46), secondary outcomes, complicated recoveries (p = .29), or deaths within 30 days of surgery (p = .14) between the 2 groups. However, the length of postoperative recovery was increased in the elderly cohort (p = .029). CONCLUSIONS: Given that outcomes were similar between young and elderly patients, surgeons should not restrict the use of free flaps based on their patients' age.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".