Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (9): 575-580.DOI: 10.12016/j.issn.2096-1456.2020.09.005
• Cinical Study • Previous Articles Next Articles
SUN Zhongyi1(),CHEN Yiming2,WANG Yi3(
),JI Tong2(
)
Received:
2020-04-12
Revised:
2020-05-26
Online:
2020-09-20
Published:
2020-08-24
Contact:
Yi WANG,Tong JI
通讯作者:
汪轶,季彤
作者简介:
孙中毅,医师,硕士,Email:基金资助:
CLC Number:
SUN Zhongyi,CHEN Yiming,WANG Yi,JI Tong. 55 cases of perioperative mortality in oral maxillofacial head and neck cancer patients: a retrospective analysis[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(9): 575-580.
孙中毅,陈一铭,汪轶,季彤. 55例口腔颌面头颈部恶性肿瘤患者围手术期死亡病例回顾性分析[J]. 口腔疾病防治, 2020, 28(9): 575-580.
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Variable | n | |
---|---|---|
Age[median number (min-max),y] | 63(24-88) | |
Sex | Male | 39 |
Female | 16 | |
Smoking history | Yes | 12 |
No | 43 | |
General morbidity | Yes | 28 |
No | 27 | |
Tumor recurrence | Yes | 20 |
No | 35 | |
Previous operation | Yes | 24 |
No | 31 | |
Previous radiotherapy | Yes | 20 |
No | 35 | |
Previous chemotherapy | Yes | 9 |
No | 46 | |
Receive operation (this time) | Yes | 51 |
No | 4 | |
ASA grade | Ⅰ | 1 |
Ⅱ | 33 | |
Ⅲ | 16 | |
IV | 4 | |
V | 1 | |
Operation time [median number (min-max), min] | 420(60-780) | |
Operative blood loss [median number (min-max), mL] | 600(50-1 400) | |
Airway management | Tracheotomy | 37 |
Throat colostomy | 2 | |
No | 6 | |
POM time classification | Preoperative | 4 |
Intraoperative | 1 | |
Postoperative | 50 | |
POM complication classification | Surgical | 12 |
Medical | 31 | |
Mixed | 10 | |
Personal | 2 |
Tab 1 Clinical and demographic characteristics of the patients n = 55
Variable | n | |
---|---|---|
Age[median number (min-max),y] | 63(24-88) | |
Sex | Male | 39 |
Female | 16 | |
Smoking history | Yes | 12 |
No | 43 | |
General morbidity | Yes | 28 |
No | 27 | |
Tumor recurrence | Yes | 20 |
No | 35 | |
Previous operation | Yes | 24 |
No | 31 | |
Previous radiotherapy | Yes | 20 |
No | 35 | |
Previous chemotherapy | Yes | 9 |
No | 46 | |
Receive operation (this time) | Yes | 51 |
No | 4 | |
ASA grade | Ⅰ | 1 |
Ⅱ | 33 | |
Ⅲ | 16 | |
IV | 4 | |
V | 1 | |
Operation time [median number (min-max), min] | 420(60-780) | |
Operative blood loss [median number (min-max), mL] | 600(50-1 400) | |
Airway management | Tracheotomy | 37 |
Throat colostomy | 2 | |
No | 6 | |
POM time classification | Preoperative | 4 |
Intraoperative | 1 | |
Postoperative | 50 | |
POM complication classification | Surgical | 12 |
Medical | 31 | |
Mixed | 10 | |
Personal | 2 |
Systemic comorbidity | Number |
---|---|
Hypertension | 15 |
Diabetes | 6 |
Cerebral infarction | 2 |
Epilepsy | 1 |
COPD | 3 |
Premature beat | 2 |
Hypoproteinemia | 1 |
Cerebral hemorrhage | 1 |
MI | 4 |
CHD | 13 |
SS | 1 |
Raynaud′s disease | 1 |
CGN | 1 |
Asthma | 1 |
Table 2 Composition of systemic comorbidities
Systemic comorbidity | Number |
---|---|
Hypertension | 15 |
Diabetes | 6 |
Cerebral infarction | 2 |
Epilepsy | 1 |
COPD | 3 |
Premature beat | 2 |
Hypoproteinemia | 1 |
Cerebral hemorrhage | 1 |
MI | 4 |
CHD | 13 |
SS | 1 |
Raynaud′s disease | 1 |
CGN | 1 |
Asthma | 1 |
Diagnosis and region | n | |
---|---|---|
Squamous cell carcinoma mucosa | Maxilla and skull base | 2 |
Mandible | 10 | |
Buccal | 8 | |
Tongue | 7 | |
Cervical | 4 | |
Parapharyngeal | 5 | |
Parotid | 1 | |
Osteosarcoma | Maxilla and skull base | 1 |
Chondrosarcoma | Maxilla and skull base | 1 |
Malignant hemangioendothelioma | Buccal | 1 |
Ameloblastoma | Mandible | 1 |
ACC | Maxilla and skull base | 1 |
MEC | Cervical | 3 |
Parotid | 1 | |
Lymphoma | Maxilla and skull base | 1 |
Epidermoid carcinoma | Infraorbital | 1 |
Inflammatory myofibroblastic tumor with local malignancy | Maxilla and skull base | 3 |
Mandible | 3 | |
Malignant hemangioendothelioma | Buccal | 1 |
Total | 55 |
Table 3 Pathological diagnosis and tumor region
Diagnosis and region | n | |
---|---|---|
Squamous cell carcinoma mucosa | Maxilla and skull base | 2 |
Mandible | 10 | |
Buccal | 8 | |
Tongue | 7 | |
Cervical | 4 | |
Parapharyngeal | 5 | |
Parotid | 1 | |
Osteosarcoma | Maxilla and skull base | 1 |
Chondrosarcoma | Maxilla and skull base | 1 |
Malignant hemangioendothelioma | Buccal | 1 |
Ameloblastoma | Mandible | 1 |
ACC | Maxilla and skull base | 1 |
MEC | Cervical | 3 |
Parotid | 1 | |
Lymphoma | Maxilla and skull base | 1 |
Epidermoid carcinoma | Infraorbital | 1 |
Inflammatory myofibroblastic tumor with local malignancy | Maxilla and skull base | 3 |
Mandible | 3 | |
Malignant hemangioendothelioma | Buccal | 1 |
Total | 55 |
POM | Number | |
---|---|---|
Preoperative POM- Medical | MI | 1 |
Heart failure | 1 | |
Electrolyte disturbance | 1 | |
Pulmonary infection | 1 | |
Intraoperative POM- Surgical | Hemorrhage | 1 |
Postoperative POM- Surgical | Rupture of carotid artery | 8 |
Asphyxia caused by hematoma | 3 | |
Postoperative POM- Medical | Pulmonary embolism | 5 |
MI | 5 | |
Heart failure | 1 | |
Electrolyte disturbance | 1 | |
Pulmonary infection | 6 | |
Cardiopulmonary arrest | 2 | |
Pancreatitis | 1 | |
MODS | 7 | |
MODS+DIC | 1 | |
Shock | 1 | |
Mix | ||
Pulmonary infection+Hemorrhage | 4 | |
Aspiration+ Pulmonary infection+ MODS+ Hemorrhage | 2 | |
Postoperative hemiplegia+ Pulmonary infection | 1 | |
Pulmonary embolism+ Urinary tract infection | 1 | |
MODS+DIC+ Hemorrhage | 1 | |
Personal: fall from cycling | 1 | |
Personal: patient′s relatives refuses rescue | 1 | |
Total | 55 |
Table 4 Etiology composition of perioperative mortality
POM | Number | |
---|---|---|
Preoperative POM- Medical | MI | 1 |
Heart failure | 1 | |
Electrolyte disturbance | 1 | |
Pulmonary infection | 1 | |
Intraoperative POM- Surgical | Hemorrhage | 1 |
Postoperative POM- Surgical | Rupture of carotid artery | 8 |
Asphyxia caused by hematoma | 3 | |
Postoperative POM- Medical | Pulmonary embolism | 5 |
MI | 5 | |
Heart failure | 1 | |
Electrolyte disturbance | 1 | |
Pulmonary infection | 6 | |
Cardiopulmonary arrest | 2 | |
Pancreatitis | 1 | |
MODS | 7 | |
MODS+DIC | 1 | |
Shock | 1 | |
Mix | ||
Pulmonary infection+Hemorrhage | 4 | |
Aspiration+ Pulmonary infection+ MODS+ Hemorrhage | 2 | |
Postoperative hemiplegia+ Pulmonary infection | 1 | |
Pulmonary embolism+ Urinary tract infection | 1 | |
MODS+DIC+ Hemorrhage | 1 | |
Personal: fall from cycling | 1 | |
Personal: patient′s relatives refuses rescue | 1 | |
Total | 55 |
Variable | Median time (day) | Range (day) | |
---|---|---|---|
Age (years) | ≤ 65 | 11 | 3-65 |
>65 | 10 | 2-120 | |
Sex | Male | 10 | 2-120 |
Female | 16 | 3-42 | |
Smoking history | Yes | 13 | 5-35 |
No | 10 | 2-120 | |
General morbidity | Yes | 8 | 2-65 |
No | 11 | 2-120 | |
Tumor recurrence | Yes | 14.5 | 3-30 |
No | 10 | 2-120 | |
Previous operation | Yes | 11 | 3-65 |
No | 10 | 2-120 | |
Previous radiotherapy | Yes | 10 | 2-65 |
No | 11 | 2-120 | |
Previous chemotherapy | Yes | 8 | 2-65 |
No | 11 | 2-120 | |
ASA grade | Ⅰ | 10 | - |
Ⅱ | 11 | 3-120 | |
Ⅲ | 10 | 2-65 | |
Ⅳ | 5 | 2-8 | |
Ⅴ | 8 | - | |
Operation time(min) | ≤ 420 | 10 | 3-65 |
>420 | 10 | 2-120 | |
Operative blood loss(ml) | ≤ 600 | ||
>600 | 12 | 3-120 | |
Airway management | Tracheotomy | 10 | 2-65 |
Throat colostomy | 7.5 | 5-10 | |
No | 14 | 3-120 | |
Mortality composition | Surgical | 10 | 3-15 |
Medical | 14 | 2-120 | |
Mix | 12.5 | 3-30 | |
Personal | 12 | 2-22 |
Table 5 The time characteristic of perioperative mortality under different variables
Variable | Median time (day) | Range (day) | |
---|---|---|---|
Age (years) | ≤ 65 | 11 | 3-65 |
>65 | 10 | 2-120 | |
Sex | Male | 10 | 2-120 |
Female | 16 | 3-42 | |
Smoking history | Yes | 13 | 5-35 |
No | 10 | 2-120 | |
General morbidity | Yes | 8 | 2-65 |
No | 11 | 2-120 | |
Tumor recurrence | Yes | 14.5 | 3-30 |
No | 10 | 2-120 | |
Previous operation | Yes | 11 | 3-65 |
No | 10 | 2-120 | |
Previous radiotherapy | Yes | 10 | 2-65 |
No | 11 | 2-120 | |
Previous chemotherapy | Yes | 8 | 2-65 |
No | 11 | 2-120 | |
ASA grade | Ⅰ | 10 | - |
Ⅱ | 11 | 3-120 | |
Ⅲ | 10 | 2-65 | |
Ⅳ | 5 | 2-8 | |
Ⅴ | 8 | - | |
Operation time(min) | ≤ 420 | 10 | 3-65 |
>420 | 10 | 2-120 | |
Operative blood loss(ml) | ≤ 600 | ||
>600 | 12 | 3-120 | |
Airway management | Tracheotomy | 10 | 2-65 |
Throat colostomy | 7.5 | 5-10 | |
No | 14 | 3-120 | |
Mortality composition | Surgical | 10 | 3-15 |
Medical | 14 | 2-120 | |
Mix | 12.5 | 3-30 | |
Personal | 12 | 2-22 |
Condition | POM composition | P | ||||
---|---|---|---|---|---|---|
Surgical | Medical | Mix | Personal | |||
ASA | 1 | 1 | 0 | 0 | 0 | 0.039 |
2 | 9 | 15 | 8 | 0 | ||
3 | 2 | 12 | 2 | 1 | ||
4 | 0 | 3 | 0 | 1 | ||
5 | 0 | 1 | 0 | 0 | ||
Age | ≤ 65 | 9 | 15 | 6 | 0 | 0.170 |
>65 | 3 | 16 | 4 | 2 | ||
Airway management | Yes | 10 | 22 | 6 | 1 | 0.594 |
No | 2 | 9 | 4 | 1 | ||
General morbidity | Yes | 4 | 17 | 6 | 1 | 0.571 |
No | 8 | 14 | 4 | 1 | ||
Previous radiotherapy | Yes | 5 | 10 | 5 | 0 | 0.509 |
No | 7 | 21 | 5 | 2 | ||
Previous chemotherapy | Yes | 4 | 4 | 1 | 0 | 0.323 |
No | 8 | 27 | 9 | 2 | ||
Tumor recurrence | Yes | 6 | 11 | 3 | 0 | 0.514 |
No | 6 | 20 | 7 | 2 | ||
Blood loss(mL) | ≤ 600 | 7 | 19 | 7 | 2 | 0.674 |
> 600 | 5 | 12 | 3 | 0 | ||
Operation time(min) | ≤ 420 | 7 | 15 | 6 | 1 | 0.896 |
>420 | 5 | 16 | 4 | 1 |
Table 6 Analysis of the composition of perioperative mortality under different condition
Condition | POM composition | P | ||||
---|---|---|---|---|---|---|
Surgical | Medical | Mix | Personal | |||
ASA | 1 | 1 | 0 | 0 | 0 | 0.039 |
2 | 9 | 15 | 8 | 0 | ||
3 | 2 | 12 | 2 | 1 | ||
4 | 0 | 3 | 0 | 1 | ||
5 | 0 | 1 | 0 | 0 | ||
Age | ≤ 65 | 9 | 15 | 6 | 0 | 0.170 |
>65 | 3 | 16 | 4 | 2 | ||
Airway management | Yes | 10 | 22 | 6 | 1 | 0.594 |
No | 2 | 9 | 4 | 1 | ||
General morbidity | Yes | 4 | 17 | 6 | 1 | 0.571 |
No | 8 | 14 | 4 | 1 | ||
Previous radiotherapy | Yes | 5 | 10 | 5 | 0 | 0.509 |
No | 7 | 21 | 5 | 2 | ||
Previous chemotherapy | Yes | 4 | 4 | 1 | 0 | 0.323 |
No | 8 | 27 | 9 | 2 | ||
Tumor recurrence | Yes | 6 | 11 | 3 | 0 | 0.514 |
No | 6 | 20 | 7 | 2 | ||
Blood loss(mL) | ≤ 600 | 7 | 19 | 7 | 2 | 0.674 |
> 600 | 5 | 12 | 3 | 0 | ||
Operation time(min) | ≤ 420 | 7 | 15 | 6 | 1 | 0.896 |
>420 | 5 | 16 | 4 | 1 |
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