Analysis of perioperative mortality in 66 patients with head and neck cancer: A retrospective study

To investigate the characteristics, causes, and risk factors of perioperative mortality (POM) in patients undergoing surgery for head and neck cancer (HNC).

Medical records of HNC patients treated between 1999 and 2024 were reviewed. Sixty-six patients who experienced POM were identified and compared with 132 matched controls (matched for tumor site, stage, and type of surgery). Data included demographics, comorbidities, tumor features, treatment history, perioperative management, and causes of death. POM causes were categorized as surgical, medical, mixed, or personal. Risk factors were assessed using univariate and multivariate logistic regression.

Among 198 patients (66 POM, 132 controls), those with POM were older, had more comorbidities, advanced disease, and prior radiotherapy. They also showed higher ASA grades, longer operations, greater blood loss, and more frequent tracheotomy (all p < 0.05). Most deaths occurred postoperatively, with medical complications predominating. Independent predictors of POM were comorbidities, advanced stage, ASA grade 600 ml, and tracheotomy.

Perioperative mortality in HNC surgery results from multifactorial causes, with both surgical and medical complications contributing significantly. Identifying high-risk patients based on preoperative status and operative parameters may help optimize perioperative care and reduce mortality.