title: Pneumonia after endoscopic resection for gastric neoplasm.
abstract: BACKGROUND
  Pneumonia following endoscopic procedures may affect the clinical course and prolong hospital stay.
  
  
  OBJECTIVE
  To investigate the incidence and risk factors for pneumonia after endoscopic resection (ER) for gastric neoplasm.
  
  
  METHODS
  Subjects who underwent ER for gastric neoplasm at the Asan Medical Center from January 1997 to March 2013 were included. To investigate risk factors, control patients were randomly selected from these subjects.
  
  
  RESULTS
  Of the 7,149 subjects who underwent ER for gastric neoplasm, 44 (0.62 %) developed pneumonia. The median age of these 44 patients was 68 years (range 31-82 years), and the male to female ratio was 3:1. Twenty-five of the pneumonia patients (56.8 %) were smokers, and 8 (18.2 %) had underlying pulmonary diseases. The median procedure time was 23 min (range 2-126 min), and pathologic diagnoses included adenocarcinoma (n = 29), dysplasia (n = 10), and hyperplastic polyp (n = 5). Compared with the control group, smoking (current smoker vs. never smoker, odds ratio [OR] 2.366, p = 0.021), total procedure time (OR 1.011, p = 0.048), and hemostasis time (OR 1.026, p = 0.028) were risk factors for the development of pneumonia. In multivariate analysis, age >65 years (OR 2.073, p = 0.031), smoking (current smoker vs. never smoker, OR 2.324, p = 0.023), and hemostasis time (OR 1.025, p = 0.038) were independent risk factors. All patients recovered from pneumonia, and the duration of hospital stay did not differ between patients with pneumonia and the control group (p = 0.077).
  
  
  CONCLUSIONS
  Whereas old age, smoking, and longer hemostasis time are risk factors for pneumonia, its incidence after ER is not associated with clinically significant adverse outcomes.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Eun Jeong
authors.initials: EJ
authors.lastname: Gong
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Hyun
authors.initials: H
authors.lastname: Lim
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Kwi-Sook
authors.initials: KS
authors.lastname: Choi
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Seunghee
authors.initials: S
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016022:Case-Control Studies; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006487:Hemostasis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011015:Pneumonia, Aspiration / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking; D013274:Stomach Neoplasms / Q000601:surgery*