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计算机断层扫描定义的肌肉减少症是口腔癌游离皮瓣重建患者短期术后并发症的危险因素:一项基于人群的回顾性队列研究。

Computed tomography-defined sarcopenia as a risk factor for short-term postoperative complications in oral cancer patients with free flap reconstruction: A retrospective population-based cohort study.

机构信息

Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.

Department of Oral and Maxillofacial Surgery, Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, Guangdong, China.

出版信息

Head Neck. 2023 Oct;45(10):2555-2570. doi: 10.1002/hed.27479. Epub 2023 Aug 10.

Abstract

BACKGROUND

Postoperative complications after free flap reconstruction for oral cancer can increase cost and prolong hospitalization. This study explored risk factors for complications, focusing on sarcopenia.

METHODS

The study explored the associations between computed tomography-defined sarcopenia and the occurrence of postoperative complications, adjusted for age, gender, smoking, alcohol, ASA scoring, clinical stage of tumor, tumor site, type of free flap used, presence of tracheotomy, and blood test parameters.

RESULTS

Of 253 patients, 17.39% (44/253) of oral cancer patients had comorbid sarcopenia. Univariate analysis showed an overall postoperative complication rate of 65.90% in the sarcopenia group and 51.67% in the non-sarcopenia group. Multivariate modeling showed sarcopenia and smoking were major risk factors for total and respiratory complications, increasing the risks by over two-fold. No factors significantly impacted surgery-specific complications.

CONCLUSIONS

This study identified sarcopenia as a risk factor for postoperative complications in oral cancer patients undergoing flap reconstruction.

摘要

背景

口腔癌游离皮瓣重建术后的并发症可能会增加成本并延长住院时间。本研究探讨了并发症的风险因素,重点关注肌肉减少症。

方法

本研究通过计算机断层扫描定义的肌肉减少症与术后并发症的发生之间的关系,调整了年龄、性别、吸烟、饮酒、ASA 评分、肿瘤临床分期、肿瘤部位、游离皮瓣类型、气管切开术的存在以及血液检查参数。

结果

在 253 名患者中,17.39%(44/253)的口腔癌患者存在合并性肌肉减少症。单因素分析显示,肌肉减少症组的总体术后并发症发生率为 65.90%,非肌肉减少症组为 51.67%。多变量模型显示,肌肉减少症和吸烟是总并发症和呼吸并发症的主要危险因素,使风险增加了两倍多。没有任何因素显著影响手术特定并发症。

结论

本研究确定了肌肉减少症是口腔癌游离皮瓣重建患者术后并发症的一个风险因素。

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