自由皮瓣患者术后护理的趋势是从常规重症监护病房入住转变为专科恢复单元。本研究旨在调查常规围手术期临床评估中预测其与鳞状细胞癌（OSCC）口腔重建手术高危患者有关的预期参数，这些患者预计会与延长ICU住院时间直接相关。所有接受游离皮瓣重建术的OSCC切除术患者并在ICU接受管理的患者纳入本研究。主要结果为ICU住院时间。使用单组检验（t检验，方差分析，相关系数，效应大小）和多元回归分析检验分析围手术期、手术期和术后期参数。P值设为< 0.005，被认为具有统计学意义。研究纳入了136例同质患者，平均ICU住院时间为4.5（±4.43天）。具有术前肾功能异常（P = 0.004）、术后并发症（P = 0.028）、周围血管疾病（P < 0.001）或NYHA分级心力衰竭III级阳性（P < 0.001）的患者被认定为ICU住院时间显著延长的高危患者。围手术期严重肾功能异常、周围血管疾病、术后并发症或高NYHA分级患者更容易出现ICU延长住院时间。还考虑了几个因素作为混杂因素，与其他变量结合起来增加了ICU管理时间。此外，在高危患者中，高度训练有素的医疗支持的存在，包括适当的护理照料，比无这些危险因素的患者更为关键。 © 2023. BioMed Central Ltd., part of Springer Nature.

The trend in postoperative care for free flap patients is to deescalate from routine ICU admission into a specialty recovery unit. This study aims to investigate the predictive parameters in a routine perioperative clinical assessment that are expected to be directly correlated with prolonged ICU length of stay in at-risk patients who received oral reconstructive surgery for squamous cell carcinoma (OSCC).All patients who underwent ablative surgery for OSCC with free flap reconstruction and were managed in the ICU were included in this study. The primary outcome was ICU-length of stay. Perioperative, operative and postoperative parameters were analyzed using single test ( t-test, ANOVA analysis, correlation coefficients, effect size) and multivariate regression test. The P-value was set as < 0.005 to be considered statically significant.The study included 136 homogeneous patients, with a mean ICU length of stay of 4.5 (± 4.43 day). Patients with pre-operative positive renal dysfunction (P = 0.004), peripheral vascular disease (P < 0.001), postoperative complications (P = 0.028) or positive heart failure class III (P < 0.001 ) were recognized as at-risk patients for a significantly longer ICU length of stay.Patients with perioperative severe renal dysfunction, peripheral vascular disease, postoperative complication or high NYHA class are prone to have a significantly longer ICU length of stay. Several factors were considered as confounders contributing to increased ICU management time in combination with other variables. Additionally, in highly risk patient, the presence of the highly trained medical support, including the appropriate nursing care, is more critical than those patients without these risk factors.© 2023. BioMed Central Ltd., part of Springer Nature.