Postoperative pulmonary complications following head and neck oncosurgery - Case control study

Abstract

Head and neck cancers (HNC) constitute about one-third of all cancers in India. A combination of surgery, chemotherapy and radiotherapy is used to manage them. There is a high incidence of PPCs following head and neck surgeries. The probable mechanisms behind it are alteration in swallowing mechanisms and impairment in protective factors of the laryngeal apparatus.To study the association between the clinicodemographic and perioperative parameters and the occurrence of PPCs following head and neck oncosurgery. This case-control study was conducted in150 patients after head and neck oncosurgery. 50 patients as cases with complications and 100 patients as control with no complications were included in the study after getting informed consent and results were statistically analyzed and discussed. A pre-tested semi-structured case study form was used to collect patient information. Mean ages among cases and controls were 58.76 ± 10.40 and 56.10 ± 12.61. Weight loss was present in 26% of patients and 8% of controls. Malignancy of the tongue was the most common among both patients and controls, constituting 22% and 25%, respectively, followed by mouth and larynx. Preoperative albumin levels, presence of ARI within one month of surgery and lack of preoperative pulmonary rehabilitation had a significant association with the development of PPCs.From this study, we concluded correction of the modifiable preoperative risk factors might prove beneficial in reducing the incidence of PPCs.