Perioperative mortality of head and neck cancers

Wang, Yannan; Wang, Mengxue; Sun, Bincan; Wang, Kai; Zhu, Feiya

doi:10.21203/rs.3.rs-109862/v1

“…SSI can prolong hospital stays, increase medical costs and, in severe cases, even lead to death [2,8]. Our previous studies have shown that SSI is associated with increased perioperative mortality and poorer OS in HNC patients [9]. In this study, we found that SSI increased the ap failure rate and the length of postoperative hospital stay.…”

Section: Discussionsupporting

confidence: 53%

“…Meanwhile, SSI increases the mortality during the perioperative period. In our previous study we found that SSI is a risk factor for perioperative death of HNC and it is signi cantly correlated with poor overall survival (OS) of HNC patients [9].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for surgical site infection in head and neck cancer

Gan¹,

Wang

²

,

Tang

³

et al. 2021

Support Care Cancer

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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...

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“…[2,8]. Our previous studies have shown that SSI is associated with increased perioperative mortality and poorer OS in HNC patients [9]. In this study, we found that SSI increased the ap failure rate and the length of postoperative hospital stay.…”

Section: Multivariate Logistic Regression Analysis Of Risk Factors Of Ssi In Hnc Patientssupporting

confidence: 58%

“…Meanwhile, SSI increases the mortality during the perioperative period. In our previous study we found that SSI is a risk factor for perioperative death of HNC and it is signi cantly correlated with poor overall survival (OS) of HNC patients [9]. The patients' data was collected and sorted from our hospital's electronic database, which contains prior medical records and postoperative follow-up information.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Surgical Site Infection in Head and Neck Cancer

Gan

¹

,

Wang

²

,

Tang

³

et al. 2021

Preprint

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0

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Purpose 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 definitive conclusion about the risk factors of SSI. Therefore, it is of great clinical significance to study the factors affecting the SSI. Methods The 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. Results Participants 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 (floor of mouth) and flap failure were consistently ranked the top three in the 26 SSI-related risk factors. In addition, SSI can increase postoperative hospital stays and flap failure rate. Conclusion Diabetes mellitus, tumor site (floor of mouth), flap failure, preoperative radiotherapy, neck dissection (bilateral) are risk factors for SSI of HNC.

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“…HNC-specific reasons can be rupture of large vessels in advanced disease. Cardiovascular or respiratory failure is other frequent reasons, mainly attributed to the severe comorbidity of the patients [22]. Second, this study was retrospective, which could lead to misclassification error and unmeasured variables.…”

Section: Discussionmentioning

confidence: 98%

Mortality during In-Hospital Treatment for Head and Neck Cancer in Germany: A Diagnosis-Related Group-Based Nationwide Analysis, 2005–2018

Hermanns

¹

,

Kouka

²

,

Guntinas‐Lichius

³

2022

Journal of Oncology

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Background. Data on in-hospital MR (IHMR) of head and neck cancer (HNC) are sparse. Methods. IHMR was determined in Germany between 2005 and 2018 using nationwide population-based diagnosis-related group (DRG) data of 1,090,596 HNC. Results. The overall average IHMR was 0.04 ± 0.02 . IHMR increased with older age to 0.04 ± 0.01 for patients of 65-79 years of age (relative risk [RR] in relation to patients of 35-49 years of age = 1.767 ; 95 % confidence interval CI = 1.040 to3.001) to a maximum of 0.07 ± 0.01 for patients of 80 years and older ( RR = 2.826 ; CI = 1.663 to 4.803). IHMR was the highest when no HNC-specific treatment, i.e., best supportive and palliative care, was applied ( 0.11 ± 0.01 ; RR in relation to tumor biopsy surgery = 7.241 ; CI = 3.447 to 5.211). IHMR was not different between surgery, radiotherapy, or chemotherapy/biologicals. Conclusions. IHMR did not change over time. Efforts are needed to decrease the IHMR for HNC.

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Perioperative mortality of head and neck cancers

Cited by 3 publications

References 28 publications

Risk factors for surgical site infection in head and neck cancer

Risk factors for surgical site infection in head and neck cancer

Risk Factors for Surgical Site Infection in Head and Neck Cancer

Mortality during In-Hospital Treatment for Head and Neck Cancer in Germany: A Diagnosis-Related Group-Based Nationwide Analysis, 2005–2018

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