Nutritional and hematologic markers as predictors of risk of surgical site infection in patients with head and neck cancer undergoing major oncologic surgery.

Abstract

Surgical site infection is a complication of surgery for patients with head and neck cancer. We examined the risk factors for surgical site infection in patients undergoing surgery for head and neck cancer. The study involved 369 patients who underwent surgery for head and neck cancer. Hematological and nutritional parameters were measured preoperatively and postoperatively. Univariate and multivariate analyses were used to determine the risk factors for surgical site infection. Of the 369 patients, 104 (28.2%) had surgical site infections: 45 (12.2%) superficial incisional; 6 (1.6%) deep incisional; and 53 (14.4%) organ/space infections. Multivariate analyses showed that history of radiotherapy, weight loss at diagnosis (>5%), preoperative hypoalbuminemia, neutrophil/lymphocyte ratio (NLR), reconstructive surgery, and tracheostomy were the independent factors predictive of surgical site infection. Patients with preoperative low serum albumin levels (<3.3 g/L) had a 3-fold higher risk of surgical site infection. Our study shows that patient nutritional and hematological markers are associated with the risk of surgical site infection after major surgery for head and neck cancer.