title: Risk factors of postoperative pneumonia after lung cancer surgery.
abstract: The purpose of this study was to investigate risk factors of postoperative pneumonia (POP) after lung cancer surgery. The 417 lung cancer patients who underwent surgical resection in a tertiary referral hospital were included. Clinical, radiological and laboratory data were reviewed retrospectively. Male and female ratio was 267:150 (median age, 65 yr). The incidence of POP was 6.2% (26 of 417) and in-hospital mortality was 27% among those patients. By univariate analysis, age ≥ 70 yr (P < 0.001), male sex (P = 0.002), ever-smoker (P < 0.001), anesthesia time ≥ 4.2 hr (P = 0.043), intraoperative red blood cells (RBC) transfusion (P = 0.004), presence of postoperative complications other than pneumonia (P = 0.020), forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) < 70% (P = 0.002), diffusing capacity of the lung for carbon monoxide < 80% predicted (P = 0.015) and preoperative levels of serum C-reactive protein ≥ 0.15 mg/dL (P = 0.001) were related with risk of POP. Multivariate analysis showed that age ≥ 70 yr (OR = 3.563, P = 0.014), intraoperative RBC transfusion (OR = 4.669, P = 0.033), the presence of postoperative complications other than pneumonia (OR = 3.032, P = 0.046), and FEV(1)/FVC < 70% (OR = 3.898, P = 0.011) were independent risk factors of POP. In conclusion, patients with advanced age, intraoperative RBC transfusion, postoperative complications other than pneumonia and a decreased FEV(1)/FVC ratio have a higher risk for pneumonia after lung cancer surgery.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Lee
authors.forename: Sang-Man
authors.initials: SM
authors.lastname: Jin
authors.forename: Chang-Hoon
authors.initials: CH
authors.lastname: Lee
authors.forename: Byoung Jun
authors.initials: BJ
authors.lastname: Lee
authors.forename: Chang-Hyun
authors.initials: CH
authors.lastname: Kang
authors.forename: Jae-Joon
authors.initials: JJ
authors.lastname: Yim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Seok-Chul
authors.initials: SC
authors.lastname: Yang
authors.forename: Chul-Gyu
authors.initials: CG
authors.lastname: Yoo
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Han
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Shim
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002248:Carbon Monoxide / Q000378:metabolism; D017707:Erythrocyte Transfusion; D005260:Female; D005541:Forced Expiratory Volume; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014797:Vital Capacity
chemical_list: D002248:Carbon Monoxide; D002097:C-Reactive Protein