Sudden death after major head and neck surgery

Abstract

In more recent studies, the mortality rate after neck dissection was below 4%, which is at a lower value than reported in previous studies. Sudden deaths have been described, however, mainly during the first three postoperative days. Alcoholism and perioperative hypotension are two predictive factors for cardiac complications. Careful follow-up of these patients during the early postoperative period should be performed to reduce the mortality by shortening the delay of care.

Algorithm to predict postoperative complications in oropharyngeal and oral cavity carcinoma

“…Medical complications were reported in 20.5% of cases undergoing microvascular reconstruction, with pulmonary, cardiac, and infectious complications predominating . Postoperative complications are associated with increased hospital stay and may lead to severe or fatal outcomes …”

“…23,25 Postoperative complications are associated with increased hospital stay 26,27 and may lead to severe or fatal outcomes. 22,23,28 Several patient and disease characteristics have been identified as predictors of postoperative complications. 19,29 However, instruments to predict the probability of complications before surgery have not, to our knowledge, been reported.…”

Determinants of Outcome Following Surgery for Oral Squamous Cell Carcinoma

“…The post-operative course is related to multiple and varied factors ranging from age, co-morbidity, extent and length of surgery, type of reconstruction, and post-operative adjuvant therapy[102][103][104][105][106].Death intra or peri-operatively (<2 weeks from surgery) is reported in 3-4% of patients[102,104,106]. Alcoholism and peri-operative hypotension are two predictive factors for sudden death in the peri-operative period[106]. Other complications include wound dehiscence and infection which are reported in 20% of cases[104].…”

“…Other complications include wound dehiscence and infection which are reported in 20% of cases[104]. Contributing factors for all complications including death are pre-existing co-morbidity, in particular, cardiovascular and respiratory disease; stage of disease; extent and timing of surgery, in particular if bilateral neck dissection is performed; alcoholism; tracheostomy; poor differentiation of tumour; and ECS[102][103][104][105][106]. In general, the factors reflect either a high-risk patient or a high-risk, that is, aggressive, tumour.…”

Competing Causes of Death in 138 Patients with Loco-Regionally Advanced Head and Neck Cancer Treated with Multi-Modality Treatment

“…Our study shows the difficulty of establishing the cause of death of 3 patients (2.1%) who have undergo a heavy surgical operation. Sudden death is a rare event after major head and neck surgery and occurs mainly during the first three postoperative days [14]. Alcoholism and perioperative hypotension seems to be two predictive factors for cardiac complications and sudden death [15].…”