title: Surgical site infection in elderly oral cancer patients: is the evaluation of comorbid conditions helpful in the identification of high-risk ones?
abstract: OBJECTIVE
  This study was performed to gain some knowledge on the possible relation between surgical site infection (SSI) and geriatric patients who undergo surgical treatment of oral squamous cell carcinoma and to identify the risk factors in this specific population.
  
  
  METHODS
  A retrospective study from 2004 through 2010 at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine was conducted. The primary outcome variable was the presence of SSIs. Twenty-seven variables of the patients concerning general characteristics, comorbidities, disease information, and treatment options were investigated. A multivariate analysis using logistic regression was implemented to find SSI risk factors.
  
  
  RESULTS
  The data of 376 patients (183 men, 48.7%; 193 women, 51.3%) older than 65 years with the diagnosis of oral squamous cell carcinoma were included in the present analysis. In multivariate logistic regression analysis, 6 parameters were identified for a significant and independent association with the development of SSI: body mass index (P = .0086); diabetes (P < .0001); American Society of Anesthesiologists score (P = .0127); Adult Comorbidity Evaluation-27 score (P = .0392); operation time (P = .0003); and reconstruction with pectoralis major myocutaneous flaps or free flaps (P < .0001).
  
  
  CONCLUSIONS
  Special attention to SSIs should be given to elderly patients with oral squamous cell carcinoma. The authors advocate a preoperative evaluation of comorbidities and the selection of high-risk elderly patients for a more effective prevention of SSIs.
authors.affiliation: Department of Oral and Maxillofacial Surgery; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
authors.forename: Chun-Yue
authors.initials: CY
authors.lastname: Ma
authors.forename: Tong
authors.initials: T
authors.lastname: Ji
authors.forename: Andrew
authors.initials: A
authors.lastname: Ow
authors.forename: Chen-Ping
authors.initials: CP
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Xiang-Hui
authors.initials: XH
authors.lastname: Zhou
authors.forename: Li-Zhen
authors.initials: LZ
authors.lastname: Wang
authors.forename: Kang-De
authors.initials: KD
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002908:Chronic Disease; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D015577:Geriatric Assessment; D006304:Health Status; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D061646:Operative Time; D010369:Pectoralis Muscles / Q000637:transplantation; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016038:Skin Transplantation / Q000379:methods; D012907:Smoking; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000209:etiology*