Analysis of Risk Factors for Pneumonia in 482 Patients Undergoing Oral Cancer Surgery With Tracheotomy

Li, Li; Yuan, Weijun; Zhang, Shilei; Wang, Kewei; Ruan, Hong

doi:10.1016/j.joms.2015.08.018

Cited by 30 publications

(26 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PN‐LRTIs are common among patients managed with surgery of glossectomy, tracheotomy, and flap reconstruction. The incidence of PN‐LRTIs was 15.7% approximated with previous analyses (Chughtai et al, ; Li, Yuan, Zhang, Wang, & Ruan, ). In this study, we determined the predictive effect of the WST and the resection range of glossectomy on PN‐LRTIs in patients with TSCC.…”

Section: Discussionsupporting

confidence: 81%

Prediction of postoperative lower respiratory tract infections in tongue cancer patients based on pretreatment swallowing function

et al. 2020

View full text Add to dashboard Cite

Objectives This study investigated the predictive role of pretreatment swallowing function and surgical factors on postoperative and nosocomial lower respiratory tract infections (PN‐LRTIs). Subjects and methods A retrospective study for predicting PN‐LRTIs from January 2017 to December 2018 at Hospital of Stomatology, Sun Yat‐sen University. Patients who were newly diagnosed with tongue squamous cell carcinoma (TSCC) were enrolled. Presurgical swallowing function was assessed using water swallow test (WST) and the M.D. Anderson Dysphagia Inventory (MDADI). Results A total of 83 patients were recruited to the study. Of which 54 were men (65.1%) and 29 were women (34.9%), with the mean age of 51 years old. Thirteen (15.7%) developed PN‐LRTIs. On univariate analysis, the outcomes of WST, the MDADI scores, T stage, tongue resection range, operative time, segmental mandibulectomy, and type of neck dissection exhibited a statistical significance (p < .05). On multivariate analysis, abnormal group of WST (odds ratio [OR], 15.88; 95% CI, 2.13–118.64) and total glossectomy (OR, 12.20; 95% CI, 2.01–68.32) was demonstrated to be independent risk factors. Conclusions The WST together with the resection range of tongue can predict the postoperative risk of PN‐LRTIs collaboratively. Clinically, preventive measures and intensified care should be taken for patients with abnormal WST outcome before surgery and management of total glossectomy.

show abstract

Section: Discussionsupporting

confidence: 81%

Prediction of postoperative lower respiratory tract infections in tongue cancer patients based on pretreatment swallowing function

et al. 2020

View full text Add to dashboard Cite

show abstract

“…There were several studies that associated head and neck procedures with the development of postoperative pneumonia (Table 4 [53-58]). Li et al [53] retrospectively studied 482 oral surgery patients who received a tracheotomy, and revealed a postoperative pneumonia incidence rate of 19.7%.…”

Section: Resultsmentioning

confidence: 99%

“…Li et al [53] retrospectively studied 482 oral surgery patients who received a tracheotomy, and revealed a postoperative pneumonia incidence rate of 19.7%. Marda et al [54] conducted a retrospective study of 178 patients who underwent transoral odontoidectomy and posterior fixation, showing a postoperative pneumonia incidence of 5.6%.…”

Section: Resultsmentioning

confidence: 99%

“…Li et al [53] determined independent risk factors to be male gender (OR: 1.945; P = 0.018) and long duration of tracheotomy (OR: 1.694; P = 0.0001). Marda et al [54] reported the only significant factor for developing postoperative pneumonia for patients who underwent transoral odontoidectomy and posterior fixation was blood transfusion (P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Epidemiology and Risk Factors for Postoperative Pneumonia

et al. 2017

View full text Add to dashboard Cite

Postoperative pneumonia is a common complication of surgery, and is associated with marked morbidity and mortality. Despite advances in surgical and anesthetic technique, it persists as a frequent postoperative complication. Many studies have aimed to assess its burden, as well as associated risk factors. However, this complication varies among the different surgical specialties, and there is a paucity of reports that comprehensively evaluate this complication. Therefore, the purpose of this study was to review the epidemiology and risk factors of postoperative pneumonia in the setting of: 1) general surgery; 2) cardiothoracic surgery; 3) orthopedic and spine surgery; and 4) head and neck surgery.

show abstract

“…Oral and maxillofacial surgery is considered one of surgical factors which most likely to interfere with respiratory function and strongly linked to PPCs 4 , especially radical oral and maxillofacial cancer surgery with microvascular free tissue transfer, such as fibular free flaps. Previous studies have demonstrated that the incidence of PPCs after head and neck surgery with free flap surgery is 18.8% to 44.8% [4][5][6][7][8] , while in patients following major head and neck surgery with tracheostomy can be up to 47% 6,9 . Therefore, it is necessary to prevent and reduce the occurrence of PPCs in patients undergoing oral and maxillofacial surgery, which is a specific surgical sub-cohort within head and neck surgery, with fibular free flap reconstruction and tracheostomy.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction:a prospective, double-blind, randomized, placebo-controlled trial

Liu

Zhu²,

Zhou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Postoperative pulmonary complications (PPCs) are common and significant problems for oral and maxillofacial surgery patients. Dexmedetomidine (DEX), an α2-adrenoreceptor agonist, has been proven having lung protection effects. However, since now, there has not been final conclusion about whether DEX can reduce the incidence of PPCs. We hypothesize that, in oral and maxillofacial surgery with fibular free flap reconstruction patients, DEX may decrease the incidence of PPCs.Methods: This was a prospective, double-blind, randomized, placebo-controlled, single-centered trial with two parallel arms. A total of 160 patients at intermediate-to-high risk of PPCs undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy were enrolled and randomized to receive continuous infusion of either DEX or placebo (normal saline). 0.4 ug/kg of DEX was given over 10mins as an initial dose followed by a maintaining dose of 0.4 ug/kg/h till the second day morning after surgery. At the same time, the normal saline was administered a similar quantity. The primary outcome was the incidence of PPCs according to Clavien-Dindo score within 7 days after surgery. Results: The two groups had similar characteristics at baseline. 18(22.5%) of 80 patients administered DEX, and 32(40.0%) of 80 patient administered placebo experienced PPCs within the first 7 days after surgery (relative risk [RR] 0.563,95% confidence interval [CI] 0.346-0.916; P=0.017). In the first 7 days after surgery, the DEX group had a lower incidence of PPCs and a better postoperative survival probability (Log-rank test, P=0.019), and was less prone to occur PPCs (Cox regression, P=0.025, HR=0.516). When the total dose of DEX was more than 328μg, the patients were unlikely to have PPCs (ROC curve, AUC=0.614, P=0.009).Conclusions: For patients undergoing oral and maxillofacial surgery with fibular free flap reconstruction and tracheotomy who were at intermediate or high risk of developing PPCs, continuous infusion of DEX could decrease the occurrence of PPCs during the first 7 days after surgery and shorten the length of hospital stay after surgery, but did not increase the prevalence of bradycardia or hypotension. Trial registration: Chinese Clinical Trial Registry, www.chictr.org.cn, number: ChiCTR1800016153; Registered on May 15, 2018.

show abstract

Analysis of Risk Factors for Pneumonia in 482 Patients Undergoing Oral Cancer Surgery With Tracheotomy

Cited by 30 publications

References 18 publications

Prediction of postoperative lower respiratory tract infections in tongue cancer patients based on pretreatment swallowing function

Prediction of postoperative lower respiratory tract infections in tongue cancer patients based on pretreatment swallowing function

The Epidemiology and Risk Factors for Postoperative Pneumonia

Dexmedetomidine for prevention of postoperative pulmonary complications in patients after oral and maxillofacial surgery with fibular free flap reconstruction:a prospective, double-blind, randomized, placebo-controlled trial

Contact Info

Product

Resources

About