Nutritional and hematologic markers as predictors of risk of surgical site infection in patients with head and neck cancer undergoing major oncologic surgery

Son, Ho-Jin; Choi, Seung‐Ho; Nam, Soon Yuhl; Kim, Sang Yoon

doi:10.1002/hed.25031

Cited by 30 publications

(22 citation statements)

References 47 publications

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“…A low incidence of SSI is directly related to an adequate surgical technique and is commonly used as an indicator of quality and safety in hospital care 17 . The incidence of SSI in this study was 6.4%, higher than the incidence reported by the CDC (3.5%) 18 and lower than that reported in other studies 8 , 9 , 19 – 21 , which have described an incidence of up to 85%. Our patients were mostly men (84% men and 16% women) with a mean age of 65.8 years, in line with what has been reported in other neck surgery studies 22 .…”

Section: Discussioncontrasting

confidence: 78%

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

Alonso-García

Toledano-Muñoz

Aparicio-Fernández

et al. 2021

Sci Rep

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Health care-related infections are frequent and among them surgical site infection (SSI) are the most frequent in hospitals. The objective was to evaluate the adequacy of antibiotic prophylaxis in patients undergoing neck surgery and its relationship with the incidence of surgical site infection (SSI). Prospective cohort study. The adequacy of antibiotic prophylaxis in patients undergoing neck surgery was evaluated. Antibiotic prophylaxis was considered adequate when it conformed to all items of the protocol (antibiotic used, time of administration, administration route, dose and duration). The cumulative incidence of SSI was calculated, and the relationship between SSI and antibiotic prophylaxis adequacy was determined using adjusted relative risk (RR). Antibiotic prophylaxis was administered in 63 patients and was adequate in 85.7% (95% CI 75.0–92.3) of them. The cumulative incidence of SSI was 6.4% (95% CI 3.4–11.8). There was no significant relationship between antibiotic prophylaxis inadequacy and the incidence of SSI (RR = 2.4, 95% CI 0.6–10.6). Adequacy of antibiotic prophylaxis was high and it did not affect the incidence of SSIs.

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Section: Discussioncontrasting

confidence: 78%

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

Alonso-García

Toledano-Muñoz

Aparicio-Fernández

et al. 2021

Sci Rep

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“…This observation was consistent with that of previous studies. 5 , 15 , 33 , 34 As an adjuvant therapy for oral cancer, radiotherapy eliminates cancerous cells but also damages healthy cells, leading to problems with wound healing. 14 These side-effects from radiation-induced DNA mutations, microvascular damage and soft tissue fibrosis reduce collagen deposition and angiogenesis during wound healing.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China

et al. 2020

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Objective To identify risk factors associated with surgical site infection (SSI) after major oral oncological surgery. Methods This retrospective study reviewed data from patients that underwent major surgery for oral cancer at a tertiary referral hospital in China between January 2005 and July 2016. SSI was diagnosed within 30 days. Demographic, cancer-related, preoperative, perioperative and postoperative data were analysed using descriptive statistics and univariate and multivariate analyses of the risk factors for SSI. Results A total of 786 patients were enrolled, of whom 125 had SSI (15.9%), which were all incisional. Independent risk factors for SSI, identified by multivariate analysis, were diabetes mellitus (odds ratio [OR] 2.147, 95% confidence interval [CI] 1.240, 3.642), prior radiotherapy (OR 4.595, 95% CI 1.293, 17.317) and oral–neck communication (OR 2.838, 95% CI 1.263, 7.604); and factors reflecting large extent resections were tracheostomy (OR 2.235, 95% CI 1.435, 3.525), anterolateral thigh flap (OR 1.971, 95% CI 1.103, 3.448) and latissimus dorsi flap (OR 4.178, 95% CI 1.325, 13.189). Conclusions Multiple risk factors were associated with SSI after major oral oncological surgery. To minimize SSI risk, surgeons managing oral cancer patients should have a better understanding of the risk factors, including diabetes mellitus, prior radiotherapy, tracheostomy, oral–neck communication and flap reconstruction.

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“…In a registry study of more than 2000 patients who underwent laryngectomy, the overall wound complication rate was 10.0% and in adjusted analyses hypoalbuminemia (odds ratio, 1.90; 95% confidence interval, 1.32–2.74) was independently associated with postoperative wound complications; other risk factors were an operative time of more than 10 h, prior exposure to radiation therapy, presence of diabetes, preoperative anemia, and thrombocytosis [ 162 ]. In a study of cancer patients undergoing head and neck surgery, there was a surgical site infection rate of 104/399 (28%); patients with preoperative hypoalbuminemia (<3.3 g/dL) had a 3-fold higher risk of surgical site infection [ 163 ]. In oral cancer surgery, it has also been reported that early postoperative hypoalbuminemia (<2.5 g/dL) is an independent risk factor for the development of surgical site infections.…”

Section: Hypoalbuminemia and Prognosis In Infectionsmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

158

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Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

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Nutritional and hematologic markers as predictors of risk of surgical site infection in patients with head and neck cancer undergoing major oncologic surgery

Abstract: Our study shows that patient nutritional and hematological markers are associated with the risk of surgical site infection after major surgery for head and neck cancer.

Cited by 30 publications

References 47 publications

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China

Hypoalbuminemia as Surrogate and Culprit of Infections

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