Ma Chun-Yue, Ji Tong, Ow Andrew, Zhang Chen-Ping, Sun Jian, Zhou Xiang-Hui, Wang Li-Zhen, Sun Kang-De, Han Wei
Department of Oral and Maxillofacial Surgery; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
J Oral Maxillofac Surg. 2012 Oct;70(10):2445-52. doi: 10.1016/j.joms.2011.10.019. Epub 2012 Jan 21.
This study was performed to gain some knowledge on the possible relation between surgical site infection (SSI) and geriatric patients who undergo surgical treatment of oral squamous cell carcinoma and to identify the risk factors in this specific population.
A retrospective study from 2004 through 2010 at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine was conducted. The primary outcome variable was the presence of SSIs. Twenty-seven variables of the patients concerning general characteristics, comorbidities, disease information, and treatment options were investigated. A multivariate analysis using logistic regression was implemented to find SSI risk factors.
The data of 376 patients (183 men, 48.7%; 193 women, 51.3%) older than 65 years with the diagnosis of oral squamous cell carcinoma were included in the present analysis. In multivariate logistic regression analysis, 6 parameters were identified for a significant and independent association with the development of SSI: body mass index (P = .0086); diabetes (P < .0001); American Society of Anesthesiologists score (P = .0127); Adult Comorbidity Evaluation-27 score (P = .0392); operation time (P = .0003); and reconstruction with pectoralis major myocutaneous flaps or free flaps (P < .0001).
Special attention to SSIs should be given to elderly patients with oral squamous cell carcinoma. The authors advocate a preoperative evaluation of comorbidities and the selection of high-risk elderly patients for a more effective prevention of SSIs.
本研究旨在了解口腔鳞状细胞癌手术治疗的老年患者手术部位感染（SSI）与患者之间的可能关系，并确定这一特定人群中的危险因素。
对上海交通大学医学院附属第九人民医院口腔颌面外科2004年至2010年的病例进行回顾性研究。主要观察变量为SSI的发生情况。调查了患者的27项一般特征、合并症、疾病信息和治疗选择等变量。采用逻辑回归进行多变量分析以找出SSI危险因素。
本分析纳入了376例年龄大于65岁、诊断为口腔鳞状细胞癌的患者（183例男性，占48.7%；193例女性，占51.3%）。在多变量逻辑回归分析中，确定了6个与SSI发生显著且独立相关的参数：体重指数（P = .0086）；糖尿病（P < .0001）；美国麻醉医师协会评分（P = .0127）；成人合并症评估-27评分（P = .0392）；手术时间（P = .0003）；以及采用胸大肌肌皮瓣或游离皮瓣进行重建（P < .0001）。
对于老年口腔鳞状细胞癌患者应特别关注SSI。作者主张对合并症进行术前评估，并选择高危老年患者以更有效地预防SSI。
