Wang Qiang, Zhang Zhu, Zhang Shiyan, Chen Shirun
Hua Xi Kou Qiang Yi Xue Za Zhi. 2016 Apr;34(2):173-7. doi: 10.7518/hxkq.2016.02.014.
To review and analyze the risk factors of postoperative surgical site infection (SSI) in geriatric patients who undergo surgical treatment of oral squamous cell carcinoma.
A retrospective study was conducted on 143 geriatric patients who have undergone surgical treatment of oral squamous cell carcinoma. Factors were classified into four types, namely, characteristics, tumor factors, general comorbidity factors, and perioperative factors. The primary outcome variable was the presence of SSI. A logistic stepwise regression model was used for the subsequent multivariate analysis, wherein only significant risk factors in the univariate analysis were included.
Among 143 cases, 33 showed postoperative SSI. Results of univariate analysis indicated that risk factors included age, body mass index (BMI), tumor location, tumor size, diabetes, chronic obstructive pulmonary disease, American Society of Anesthesiologists (ASA) score, Charlson comorbidity index (CCI), adult comorbidity evaluation-27 (ACE-27) score, previous radiotherapy, reconstructive method, operation time, and blood transfusion. Among these factors, six parameters were identified to have a significant factor association with the development of SSI, namely BMI, diabetes, ASA score, ACE-27 score, operation time, and reconstructive method.
Special attention should be given to factors associated with the development of SSI before operation of geriatric patients with oral squamous cell carcinoma.
回顾并分析接受口腔鳞状细胞癌手术治疗的老年患者术后手术部位感染（SSI）的危险因素。
对143例接受口腔鳞状细胞癌手术治疗的老年患者进行回顾性研究。因素分为四类，即特征因素、肿瘤因素、一般合并症因素和围手术期因素。主要结局变量为是否发生SSI。采用逻辑逐步回归模型进行后续多因素分析，其中仅纳入单因素分析中有显著意义的危险因素。
143例患者中，33例出现术后SSI。单因素分析结果表明，危险因素包括年龄、体重指数（BMI）、肿瘤部位、肿瘤大小、糖尿病、慢性阻塞性肺疾病、美国麻醉医师协会（ASA）评分、Charlson合并症指数（CCI）、成人合并症评估-27（ACE-27）评分、既往放疗、重建方法、手术时间和输血。在这些因素中，确定有六个参数与SSI的发生有显著因素关联，即BMI、糖尿病、ASA评分、ACE-27评分、手术时间和重建方法。
对于接受口腔鳞状细胞癌手术治疗的老年患者，术前应特别关注与SSI发生相关的因素。
