Surgical site infection (SSI) frequently occurs in patients with head and neck cancer (HNC) after tumor resection and can lead to death in severe cases. Moreover, there is no de nitive conclusion about the risk factors of SSI. Therefore, it is of great clinical signi cance to study the factors affecting the SSI. MethodsThe HNC patients included in this study were all from the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital of Central South University (CSU), and these patients received surgical treatment in the department from January 2018 to December 2019. Univariate and multivariate regression analysis was applied to determine the risk factors of SSI. To identify the key risk factors of SSI, the caret package was used to construct three different machine learning models to investigate important features involving 26 SSI-related risk factors. ResultsParticipants were 632 HNC patients who underwent surgery in our department from January 2018 to December 2019. During the postoperative period, 82 patients suffered from SSI and surgical site infection rate (SSIR) was about 12.97%. Diabetes mellitus, tumor site ( oor of mouth) and ap failure were consistently ranked the top three in the 26 SSI-related risk factors. In addition, SSI can increase postoperative hospital stays and ap failure rate. ConclusionDiabetes mellitus, tumor site ( oor of mouth), ap failure, preoperative radiotherapy, neck dissection (bilateral) are risk factors for SSI of HNC.Many risk factors of SSI have been reported in previous studies. Such as advanced age, diabetes, smoking, preoperative radiotherapy, prior surgery, preoperative chemotherapy, advanced American Society of Anesthesiologists (ASA) grade, low preoperative white blood cell (WBC) count, hypoalbuminemia, intraoperative blood transfusion, tracheotomy, contaminated wounds, lymph node metastasis and reconstruction with myocutaneous aps or microvascular-free aps, etc. [5,7,[10][11][12][13]. However, due to the differences in study methodology, number of patients and sample size, there are still some disputes in different studies. For example, whether diabetes, tumor location or previous radiotherapy can be regarded as potential risk factors for SSI causes controversy [5,14,15]. Coskun, et.al. found diabetes mellitus, tumor location and history of prior radiotherapy were not associated statistically with wound infection in head and neck surgery (HNS) [16]. Sepehr, et al. found diabetes was not a risk factor for infection after HNS [17]. Similarly, Hitomi, et.al indicated that age, body mass index, smoking, diabetes, sex, previous radiotherapy or ASA score were not correlated with SSI [12]. However, Milap D. et.al showed HNC patients with diabetes have signi cantly greater rates of postoperative infections [18]. Margita, et.al indicated that gender, smoking, tumor localization and neck dissection were signi cantly related to the occurrence of wound infection [19]. So far, there is no clear de nition of risk factors for SSI of HNC surgery.In addition, these SSI...
Background Head and neck cancers are aggressive cancers, most clinical studies focused on the prognosis of patients with head and neck cancer. However, perioperative mortality was rarely mentioned. Methods A retrospective analysis was performed using all head and neck cancer patients admitting in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital, Central South University from January 2010 to December 2019. The analysis of overall survival and progression-free survival were performed using the Kaplan–Meier method, and cross tabulation with chi-squared testing was applied to analyze the difference in parameters between groups. Results From January 2010 to December 2019, a total of 6576 patients with head and neck cancers were admitted to our department and 7 died in the hospital, all of whom were middle-aged and elderly patients including 6 males and 1 female. The perioperative mortality rate (POMR) was about 1‰. The causes of death included acute heart failure, rupture of large blood vessels in the neck, hypoxic ischemic encephalopathy due to asphyxia, respiratory failure and cardiopulmonary arrest. Conclusion Preoperative radiotherapy, previous chemotherapy, hypertension, diabetes, advanced clinical stage and postoperative infection are risk factors for perioperative mortality of head and neck cancer.
Background: Head and neck cancers are aggressive cancers, most clinical studies focused on the prognosis of patients with head and neck cancer. However, perioperative mortality was few mentioned.Methods: A retrospective analysis was performed using all head and neck cancer patients admitting in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital, Central South University from January 2010 to December 2019. The analysis of overall survival and progression-free survival were performed using the Kaplan–Meier method. Univariate and multivariate analyses employed a logistic regression model to determine the effect of study parameters on perioperative mortality. Results: From January 2010 to December 2019, a total of 6972 patients with head and neck cancers were admitted to our department and 7 died in the hospital, all of whom were middle-aged and elderly patients including 6 males and 1 female. The perioperative mortality rate (POMR) was about 1‰. The causes of death included acute heart failure, rupture of large blood vessels in the neck, hypoxic ischemic encephalopathy due to asphyxia, respiratory failure and cardiopulmonary arrest. Conclusion: Prior radiotherapy, postoperative infection, hypertension and diabetes are risk factors for perioperative mortality of head and neck cancer.
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