Occurrence, Risk Factors, and Early Clinical Outcomes of Dysphagia on Postoperative Day 7 in Patients With Oral Cancer Undergoing Free-Flap Reconstruction Surgery: A Hospital-Based Retrospective Study

Abstract

Background: Dysphagia is common in patients with oral cancer undergoing flap reconstruction surgery. Surgical resection and reconstruction can affect the sensory and motor functions associated with swallowing. Studies on dysphagia have not investigated patients with oral cancer undergoing flap reconstruction surgery. In this hospital-based retrospective study, we examined the occurrence rates, risk factors, and clinical outcomes of dysphagia in patients with oral cancer undergoing flap reconstruction surgery. Methods: Data were collected from the Chang Gung Research Database, which includes structured and unstructured electronic medical records. These data covered the period from January 1 to November 30, 2022. A total of 892 patients were included in the study. Dysphagia was identified on the basis of NANDA International Nursing Diagnoses criteria. Univariate and multivariable logistic regression models were used for data analysis. Results: Of a total of 892 patients, 679 (76.1%) experienced dysphagia. Body mass index, smoking status, alcohol consumption, betel nut chewing, pain score, neck lymph node dissection, radiotherapy, and chemotherapy were identified as significant risk factors for dysphagia. Compared with those without dysphagia, patients with dysphagia had significantly higher rates of nasogastric tube placement and tracheostomy at discharge, longer hospital stays, and higher readmission rates. Conclusions: Dysphagia is common in patients with oral cancer undergoing flap reconstruction surgery and is associated with certain risk factors and clinical outcomes. Enhancing postoperative care and implementing targeted interventions can facilitate the development of precise treatment plans aimed at reducing the incidence of dysphagia and improving the overall quality of care for patients undergoing flap reconstruction surgery.