Association of Perioperative Complications with Vitamin D Levels in Major Head and Neck Surgery

Matthew Groysman, Shethal Bearelly, Audrey Baker, Steven J. Wang, John Symms

Research output: Contribution to journalArticlepeer-review


Objectives/Hypothesis: To investigate the association of vitamin D level and perioperative complications in patients undergoing major head and neck surgery. Study Design: Retrospective Cohort Study. Methods: A retrospective chart review was performed for all patients undergoing reconstructive head and neck surgery between December 2017 and December 2019. Data regarding patient demographics, serum 25-hydroxyvitamin D (calcidiol) level, hospital course, prior radiation, and fistula formation were collected. Patients were categorized by serum calcidiol level as deficient (<20 ng/mL) or sufficient (≧20 ng/mL) and outcomes were compared between groups. Results: Fifty-seven patients were included in the analysis. Average age at time of surgery was 62.6 ± 10.6 years. Patients with vitamin D levels <20 ng/mL were considered deficient and ≧20 ng/mL were considered sufficient. Individuals in the deficient group (n = 29) had a mean serum calcidiol level of 13.95 ± 3.95 ng/mL, whereas those in the sufficient group (n = 28) had a mean calcidiol level of 28.53 ± 5.73 ng/mL. The rate of fistula was 41.4% in the deficient group, whereas patients in the sufficient group had a rate of fistula of 14.3% (P =.038). On multivariate analysis, higher serum calcidiol level above 20 ng/mL was associated with a lower likelihood of developing fistulae with an odds ratio 0.830 (95% confidence interval: 0.718–0.960, P =.012). Conclusion: Vitamin D deficiency may play a role in development of fistula after major head and neck surgery. Level of Evidence: 4 Laryngoscope, 132:578–583, 2022.

Original languageEnglish (US)
Pages (from-to)578-583
Number of pages6
Issue number3
StatePublished - Mar 2022


  • Vitamin D
  • calcidiol
  • fistula
  • head and neck surgery

ASJC Scopus subject areas

  • Otorhinolaryngology


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