Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

Head Neck. 2021 Oct;43(10):3106-3115. doi: 10.1002/hed.26799. Epub 2021 Jul 6.

Abstract

Background: To identify risk factors for surgical site infection (SSI) and pneumonia following oral cavity tumor surgery.

Methods: Retrospective chart review of a consecutive series of patients undergoing oral cavity resection. Several clinicopathologic variables were tested for their association with SSI and pneumonia.

Results: Three hundred and forty-four cases in 330 patients were included. Incidence of SSI and pneumonia was 67 (19.5%) and 38 (11%), respectively. On multivariate analysis, marginal mandibulectomy and segmental mandibulectomy were independent risk factors for SSI, whereas time under anesthesia (TUA) was an independent risk factor for pneumonia. Receiver operating characteristic curve identified 390 min as the cutoff above which pneumonia was predicted with a high degree of accuracy.

Conclusions: In oral cavity resections, mandibulectomy predisposes to SSI. Further, prolonged TUA (>390 min) is a powerful predictor for pneumonia. As it is a modifiable risk factor, reduction in TUA might correspondingly lower the incidence of postoperative pneumonia.

Keywords: oral cancer; pneumonia; reconstruction; surgery; surgical site infection.

MeSH terms

  • Humans
  • Incidence
  • Mouth Neoplasms* / surgery
  • Pneumonia* / epidemiology
  • Pneumonia* / etiology
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology