BACKGROUND: Pulmonary complications are a primary source of increased cost and morbidity in surgically treated head and neck cancer patients. This study investigates potential risk factors related to postoperative pulmonary complications (pneumonia, adult respiratory distress syndrome (ARDS), and prolonged mechanical ventilation) in head and neck cancer patients. METHODS: Data from 144 major head and neck procedures performed at the University of Washington between 1985 and 1991 were retrospectively reviewed. Univariate and multivariate analysis were used to evaluate preoperative and perioperative variables identified as potential risk factors for postoperative pulmonary complications. RESULTS: Fifteen percent of patients had a postoperative pulmonary complication, (n = 21: 18 postoperative pneumonia; 2 ARDS; and 4 prolonged ventilation). The most common pneumonia pathogen was Staphylococcus aureus (62%). Univariate analysis identified smoking and weight loss as significant factors associated with pulmonary complications. The variables preoperative blood urea nitrogen, white blood cell count, and operative chest flap closure all approached but did not reach significance. Multivariate analysis of a subgroup of patients identified smoking history and perioperative antibiotic choice as the only independently significant variables. CONCLUSIONS: Patient smoking history was the primary variable related to postoperative pulmonary problems, with evidence of increasing risk with increased exposure. Other variables added only limited additional risk association information after multivariate analysis.
BACKGROUND:Pulmonary complications are a primary source of increased cost and morbidity in surgically treated head and neck cancerpatients. This study investigates potential risk factors related to postoperative pulmonary complications (pneumonia, adult respiratory distress syndrome (ARDS), and prolonged mechanical ventilation) in head and neck cancerpatients. METHODS: Data from 144 major head and neck procedures performed at the University of Washington between 1985 and 1991 were retrospectively reviewed. Univariate and multivariate analysis were used to evaluate preoperative and perioperative variables identified as potential risk factors for postoperative pulmonary complications. RESULTS: Fifteen percent of patients had a postoperative pulmonary complication, (n = 21: 18 postoperative pneumonia; 2 ARDS; and 4 prolonged ventilation). The most common pneumonia pathogen was Staphylococcus aureus (62%). Univariate analysis identified smoking and weight loss as significant factors associated with pulmonary complications. The variables preoperative blood urea nitrogen, white blood cell count, and operative chest flap closure all approached but did not reach significance. Multivariate analysis of a subgroup of patients identified smoking history and perioperative antibiotic choice as the only independently significant variables. CONCLUSIONS:Patient smoking history was the primary variable related to postoperative pulmonary problems, with evidence of increasing risk with increased exposure. Other variables added only limited additional risk association information after multivariate analysis.
Authors: Mary Thomas; Nebu Abraham George; Balagopal Prabhakar Gowri; Preethi Sara George; Paul Sebastian Journal: Indian J Surg Date: 2010-11-18 Impact factor: 0.656
Authors: G M Divya; Nujum Zinia; P G Balagopal; Varghese T Bipin; Iype Mathew Elizabeth; George Abraham Nebu; Thomas Shaji; Sebastian Paul Journal: Indian J Surg Oncol Date: 2017-05-30
Authors: Bryan J Dooley; Daniella Karassawa Zanoni; Marlena R Mcgill; Mahmoud I Awad; Jatin P Shah; Richard J Wong; Clara Broad; Babak J Mehrara; Ian Ganly; Snehal G Patel Journal: Head Neck Date: 2019-10-08 Impact factor: 3.147
Authors: Jonathan F Dautremont; Luke R Rudmik; Justin Yeung; Tiffany Asante; Steve C Nakoneshny; Monica Hoy; Amanda Lui; Shamir P Chandarana; Thomas W Matthews; Christiaan Schrag; Joseph C Dort Journal: J Otolaryngol Head Neck Surg Date: 2013-12-19