Predictive Factors of Atelectasis Following Endoscopic Resection.
OBJECTIVE
Atelectasis is one of the pulmonary complications associated with anesthesia. Little is known about atelectasis following endoscopic procedures under deep sedation. This study evaluated the frequency, risk factors, and clinical course of atelectasis after endoscopic resection.


METHODS
A total of 349 patients who underwent endoscopic resection of the upper gastrointestinal tract at a single academic tertiary referral center from March 2010 to October 2013 were enrolled. Baseline characteristics and clinical data were retrospectively reviewed from medical records. To identify atelectasis, we compared the chest radiography taken before and after the endoscopic procedure.


RESULTS
Among the 349 patients, 68 (19.5 %) had newly developed atelectasis following endoscopic resection. In univariate logistic regression analysis, atelectasis correlated significantly with high body mass index, smoking, diabetes mellitus, procedure duration, size of lesion, and total amount of propofol. In multiple logistic regression analysis, body mass index, procedure duration, and total propofol amount were risk factors for atelectasis following endoscopic procedures. Of the 68 patients with atelectasis, nine patients developed fever, and six patients displayed pneumonic infiltration. The others had no symptoms related to atelectasis.


CONCLUSIONS
The incidence of radiographic atelectasis following endoscopic resection was nearly 20 %. Obesity, procedural time, and amount of propofol were the significant risk factors for atelectasis following endoscopic procedure. Most cases of the atelectasis resolved spontaneously with no sequelae.
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Jung Wan
JW
Choe
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea. sungwoojung@korea.ac.kr.|Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 425-707, Korea. sungwoojung@korea.ac.kr.
Sung Woo
SW
Jung
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Jong Kyu
JK
Song
Department of Radiology, Korea University College of Medicine, Ansan, Korea.
Euddeum
E
Shim
Department of Radiology, Korea University College of Medicine, Ansan, Korea.
Ji Yung
JY
Choo
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Seung Young
SY
Kim
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Jong Jin
JJ
Hyun
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Ja Seol
JS
Koo
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Hyung Joon
HJ
Yim
Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea.
Sang Woo
SW
Lee
D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D054810:Deep Sedation / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D061646:Operative Time; D015742:Propofol / Q000009:adverse effects; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D015742:Propofol
Atelectasis; Endoscopic resection; Sedation