title: Chest tube tip culture as a predictor of postoperative infection in lung cancer operations.
abstract: BACKGROUND
  Postoperative infection is one of the most frequently observed complications after lung resection and should be addressed in perioperative management. This study evaluated the clinical significance of chest tube tip culture relevant to postoperative infection.
  
  
  METHODS
  From September 2002 to December 2011, 1,438 patients who underwent lung cancer operations in Shizuoka Cancer Center Hospital were evaluated. Postoperative infections, including surgical site infection, postoperative pneumonia, and postoperative empyema without fistula, were defined as those occurring within 30 days of thoracotomy.
  
  
  RESULTS
  Postoperative infections developed in 84 of the 1,438 patients (5.8%), including 42 (2.9%) with surgical site infection, 36 (2.5%) with pneumonia, and 13 (0.9%) with empyema. The sensitivity, specificity, and positive predictive value of chest tube tip culture were 23%, 98%, and 41.3%, respectively. Multivariate analysis demonstrated that the independent risk factors associated with the development of postoperative infections were coexisting diabetes mellitus and positive chest tube tip culture. Positive chest tube tip culture was the only independent risk factor associated with surgical site infection. The independent risk factors associated with postoperative pneumonia were age 70 years or older, coexisting diabetes mellitus, and positive chest tube tip culture. Finally, positive chest tube tip culture was the only independent risk factor associated with postoperative empyema.
  
  
  CONCLUSIONS
  Positive chest tube tip culture strongly predicts postoperative infections in lung cancer surgery and necessitates careful observation in the perioperative period.
authors.affiliation: Division of General Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. Electronic address: yoshikaney@2004.jukuin.keio.ac.jp.
authors.forename: Yoshikane
authors.initials: Y
authors.lastname: Yamauchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Isaka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Maniwa
authors.forename: Shoji
authors.initials: S
authors.lastname: Takahashi
authors.forename: Hanako
authors.initials: H
authors.lastname: Kurai
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ohde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes / Q000382:microbiology*; D016724:Empyema, Pleural / Q000382:microbiology*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D011183:Postoperative Complications / Q000382:microbiology*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: 11