This study used data from the Australia and New Zealand Audit of Surgical Mortality from the last 10 years from 1 January 2009 to 31 December 2018 for analysis. Operative decision was a common reason for surgical mortality. A multidisciplinary approach coupled with a validated risk stratification tool could reduce these deaths.
Abstract
Background
Oral squamous cell carcinoma (OSCC) is a significant public health issue. Australia had 448 deaths from lip and oral cavity cancer in 2018, some of which could be prevented. Consideration of the factors contributing to mortality after OSCC resection can provide a greater insight into how deaths can be prevented.
Methods
This paper used data from the Australia and New Zealand Audit of Surgical Mortality from the last 10 years from 1 January 2009 to 31 December 2018 for analysis. All surgical deaths were captured as the treating surgeons were mandated to complete a surgical case form for assessment by an independent surgeon from the same specialty.
Results
This study found 25 cases of death after OSCC resection. In 44% of cases, death was related to cardiac causes and 40% was related to respiratory causes. Fourteen cases were found to have issues with management, and 25 issues were raised. In 36% of issues, it was found to be related to decision to operate. There were no obvious differences between the patients who had neck dissections and those who did not.
Conclusion
The decision to operate on high‐risk patients, cardiovascular and respiratory causes were the major contributors to surgical mortality. The small number of deaths and the limitation of using existing data limited statistical analysis and conclusions. Changes could be made to the Australia and New Zealand Audit of Surgical Mortality to improve the results for analysis.
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