title: Analysis of Risk Factors for Pneumonia in 482 Patients Undergoing Oral Cancer Surgery With Tracheotomy.
abstract: OBJECTIVE
  Elective tracheostomy is a common procedure used in patients with oral cancer. However, secondary tracheotomy-associated pneumonia (TAP) is an important complication after surgery. This study investigated the risk factors related to postoperative TAP complications in patients with oral cancer.
  
  
  METHODS
  A retrospective study was performed from January 2012 to October 2013. Data on patients who had oral cancer and underwent neck dissection or reconstructive surgery with tracheotomy were collected from the Hospital Information System. The predictive variables were age, gender, alcohol history, smoking history, basic disease (including diabetes, hypertension, and cardiovascular disease), tumor location, and duration of tracheotomy, which were extracted from electronic medical records. The outcome variable was TAP. Descriptive single factors and bivariate statistics were computed and the P value was set at .05.
  
  
  RESULTS
  Four hundred eighty-two patients who received tracheotomy after oral cancer surgery were included in this study and 95 (19.7%) developed TAP. Univariate analysis showed that male gender (odds ratio [OR] = 1.853; 95% confidence interval [CI], 1.083-3.17; P = .024 to <.05), long duration of tracheotomy (OR = 1.673; 95% CI, 1.343-2.083; P < .0001), and smoking (OR = 1.656; 95% CI, 1.053-2.604; P = .029 to <.05) were risk factors for TAP. Then, 2 variables independently related to an increased risk of postoperative TAP were found by multivariate regression analysis, which were male gender (OR = 1.945; P = .018) and long duration of tracheotomy (OR = 1.694; P = .0001).
  
  
  CONCLUSIONS
  The present findings indicate that male gender and tracheotomy duration are important risk factors for TAP in patients undergoing major oral cancer surgery.
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Weijun
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Shilei
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Resident, Jiangnan University School of Medicine, Wuxi, Jiangsu, China.
authors.forename: Kewei
authors.initials: K
authors.lastname: Wang
authors.affiliation: Professor, Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: sunbook_2001@126.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Ruan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002318:Cardiovascular Diseases / Q000150:complications; D048909:Diabetes Complications; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D011014:Pneumonia / Q000209:etiology*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D013997:Time Factors; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult