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Identifying risk factors for postoperative cardiovascular and respiratory complications after major oral cancer surgery

✍ Scribed by Jasjit K. Dillon; Stanley Y. Liu; Chirag M. Patel; Brian L. Schmidt


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
165 KB
Volume
33
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Surgical resection of oral cancer can be associated with significant postoperative cardiovascular and respiratory complications that require more sensitive predictors.

Methods

All patients with oral squamous cell carcinoma treated from July 2005 to April 2008 were retrospectively reviewed. The Goldman Revised Cardiac Risk Index (GRCRI) was used to predict cardiovascular complications. Other evidence‐based a priori predictors were applied in an h‐fold cross‐validation model.

Results

Operating room (OR) time was an independent predictor of cardiovascular complications (odds ratio = 1.54, p = .002, 95% confidence interval [CI] = 1.18–2.02) and respiratory complications (odds ratio = 1.3, p = .06, 95% CI = 0.99–1.64) after multivariate adjustment. OR time and estimated blood loss predicted cardiovascular complications with 73% sensitivity. The GRCRI achieved 37% sensitivity. OR time and tracheostomy predicted respiratory complications with 75% sensitivity.

Conclusions

The GRCRI was not prognostic for cardiovascular complications in patients with oral cancer. The most sensitive predictors for cardiovascular complications were OR time and estimated blood loss; for respiratory complications they were OR time and tracheostomy. © 2010 Wiley Periodicals, Inc. Head Neck, 2011