Background <p>Postoperative vascular crisis is one of the most serious complications in patients with oral and maxillofacial malignant tumors. To date, no consensus has been reached regarding the factors influencing its occurrence. This study aimed to investigate the incidence and influencing factors of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors through a meta-analysis.</p> Methods <p>A systematic search of nine Chinese and English literature databases was conducted from database inception to August 31, 2025, to identify studies on the incidence and influencing factors of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors. Two researchers independently performed literature screening, data extraction, and quality assessment. Data were analyzed using Stata 17.0 and RevMan 5.4.1 software. Sensitivity analysis, publication bias assessment, and subgroup analysis were also performed.</p> Results <p>A total of 27 studies identified 44 influencing factors, and 13 factors were reported in at least two independent studies with complete data. The average score of the Newcastle–Ottawa Scale included in the study was ≥ 7, indicating relatively high quality. Finally, the combined incidence of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors was 14.4%, and 12 influencing factors were obtained: diabetes, hypertension, oral infection, decreased fibrinogen, decreased ALB, ALB &lt; 35g/L, preoperative radiotherapy, surgical history in the recipient area, anastomotic veins &lt; 2, history of alcohol abuse, smoking history, and gender.</p> Conclusion <p>The pooled incidence of postoperative vascular crisis in patients with oral cancer was 14.41%, indicating a relatively high risk in this population. Clinicians should develop differentiated prevention and management strategies for high-risk patients based on relevant influencing factors to improve monitoring accuracy and reduce the occurrence of vascular crisis.</p> Registration number <p>CRD420251123018.</p>

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Incidence and risk factors for postoperative vascular crisis in patients with oral and maxillofacial cancer: a systematic review and meta-analysis

  • Jiahui Liang,
  • Zhiqiang He,
  • Min Luo,
  • Min Liang,
  • Liujuan Sha,
  • Lifen Pan

摘要

Background

Postoperative vascular crisis is one of the most serious complications in patients with oral and maxillofacial malignant tumors. To date, no consensus has been reached regarding the factors influencing its occurrence. This study aimed to investigate the incidence and influencing factors of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors through a meta-analysis.

Methods

A systematic search of nine Chinese and English literature databases was conducted from database inception to August 31, 2025, to identify studies on the incidence and influencing factors of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors. Two researchers independently performed literature screening, data extraction, and quality assessment. Data were analyzed using Stata 17.0 and RevMan 5.4.1 software. Sensitivity analysis, publication bias assessment, and subgroup analysis were also performed.

Results

A total of 27 studies identified 44 influencing factors, and 13 factors were reported in at least two independent studies with complete data. The average score of the Newcastle–Ottawa Scale included in the study was ≥ 7, indicating relatively high quality. Finally, the combined incidence of postoperative vascular crisis in patients with oral and maxillofacial malignant tumors was 14.4%, and 12 influencing factors were obtained: diabetes, hypertension, oral infection, decreased fibrinogen, decreased ALB, ALB < 35g/L, preoperative radiotherapy, surgical history in the recipient area, anastomotic veins < 2, history of alcohol abuse, smoking history, and gender.

Conclusion

The pooled incidence of postoperative vascular crisis in patients with oral cancer was 14.41%, indicating a relatively high risk in this population. Clinicians should develop differentiated prevention and management strategies for high-risk patients based on relevant influencing factors to improve monitoring accuracy and reduce the occurrence of vascular crisis.

Registration number

CRD420251123018.