The prognostic implications of comorbidity and risk factors for (post)operative complications, days spent in the intensive care unit (ICU), and length of hospitalization in patients with oral squamous cell carcinoma: A prospective study

• DOI: 10.1016/j.jcms.2020.07.004
• Publication Date: 2020-07-19T05:34:14Z
• Authors: Vadim Rempel; Andrea Grandoch; Ali-Farid Safi; Johannes Buller; Maximilian Riekert; Volker Schick; Hans-Joachim Nick...; Joachim Zöller; Matthias Kreppel
• Keywords: Comorbidity; Plastic Surgery Procedures; Prognosis; 3. Good health; Hospitalization; Intensive Care Units; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Risk Factors; Carcinoma, Squamous Cell; Humans; Mouth Neoplasms; Prospective Studies; Retrospective Studies

This study aimed to investigate the prognostic implications of comorbidity/risk factors in a cohort of patients with OSCC.The prospective study included patients with biopsy-proven primary OSCC. The impact of potential predictors on (post)operative complications, days spent in the ICU, and length of hospitalization was analyzed using both univariate and multivariate analysis.Using a microvascular free flap (p = 0.009) and tobacco abuse (p = 0.005) had statistically significant impacts on postoperative complications in univariate, but not in multivariate, analysis. The duration of anesthesia (p < 0.001), type of neck dissection (p = 0.014), reconstruction type (p < 0.001), and red blood cell transfusion during operation (p = 0.007) had statistically significant impacts on spending ≥ 3 days in ICU in univariate analysis, with reconstruction type (p = 0.022) and red blood cell transfusion during operation (p = 0.034) having similar impacts in multivariate analysis. The duration of anesthesia (p < 0.001), pT (p = 0.009), type of neck dissection (p = 0.046), reconstruction type (p < 0.001), and microvascular free flap (p < 0.001) had a statistically significant impacts on length of hospitalization in univariate analysis, with reconstruction type (p < 0.001) also having a significant impact in multivariate analysis.None of the investigated variables showed a significant effect on the prediction of (post)operative complications according to the Clavien-Dindo classification. The type of reconstruction proved to be a valid predictor for the time spent in ICU as well as for the overall length of hospitalization. Red blood cell transfusion during operation further predicted the time spent in ICU after operation. Both variables should be taken into account when performing a comprehensive planning of the patients' hospitalization.