Zhang Chao, Xi Meng Ying, Zeng Jie, Li Yong, Yu Cong
Resident, Stomatological Hospital of Chongqing Medical University, Chongqing; the Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing; and the Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
Professor, Stomatological Hospital of Chongqing Medical University, Chongqing; the Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing; and the Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
J Oral Maxillofac Surg. 2019 Jul;77(7):1471-1479. doi: 10.1016/j.joms.2019.01.020. Epub 2019 Jan 26.
To investigate the relation between postoperative complications and long-term survival in patients with oral cancer after surgery and to explore the methods that improve survival rate through analyzing risk factors for postoperative complications.
This is a retrospective single-institution study of a cohort of 287 patients with oral cancer who underwent surgery at the Stomatological Hospital of the Chongqing Medical University (Chongqing, China) from January 1, 2007 through December 31, 2012.
Postoperative complications occurred in 80 patients (27.9%). Patients with pulmonary complications or delirium had worse overall survival than those without these complications, whereas other postoperative complications, such as surgical site infection, postoperative bleeding, salivary fistula, and chylothorax, were not associated with overall survival. American Society of Anesthesiologists (ASA) status and tracheostomy were risk factors for postoperative pulmonary complications according to the Pearson χ test or multivariate analysis. Using the Pearson χ test, age, comorbidity, and ASA status were risk factors for the incidence of postoperative delirium. However, in multivariate analysis, only comorbidity and ASA status were identified as risk factors.
Postoperative pulmonary complications and postoperative delirium could be independent predictors of poorer long-term survival in patients with oral cancer. The risk factors for postoperative pulmonary complications and postoperative delirium could help identify patients who are at high risk and help clinicians take some actions to prevent them.
探讨口腔癌患者术后并发症与长期生存之间的关系，并通过分析术后并发症的危险因素来探索提高生存率的方法。
这是一项在重庆医科大学附属口腔医院（中国重庆）进行的回顾性单机构研究，纳入了2007年1月1日至2012年12月31日期间接受手术的287例口腔癌患者。
80例患者（27.9%）发生术后并发症。发生肺部并发症或谵妄的患者总体生存率低于未发生这些并发症的患者，而其他术后并发症，如手术部位感染、术后出血、涎瘘和乳糜胸，与总体生存率无关。根据Pearson χ检验或多因素分析，美国麻醉医师协会（ASA）分级和气管切开术是术后肺部并发症的危险因素。使用Pearson χ检验，年龄、合并症和ASA分级是术后谵妄发生率的危险因素。然而，在多因素分析中，仅合并症和ASA分级被确定为危险因素。
术后肺部并发症和术后谵妄可能是口腔癌患者长期生存较差的独立预测因素。术后肺部并发症和术后谵妄的危险因素有助于识别高危患者，并帮助临床医生采取一些措施来预防这些并发症。
