title: Pneumonia after Major Cancer Surgery: Temporal Trends and Patterns of Care.
abstract: Rationale. Pneumonia is a leading cause of postoperative complication. Objective. To examine trends, factors, and mortality of postoperative pneumonia following major cancer surgery (MCS). Methods. From 1999 to 2009, patients undergoing major forms of MCS were identified using the Nationwide Inpatient Sample (NIS), a Healthcare Cost and Utilization Project (HCUP) subset, resulting in weighted 2,508,916 patients. Measurements. Determinants were examined using logistic regression analysis adjusted for clustering using generalized estimating equations. Results. From 1999 to 2009, 87,867 patients experienced pneumonia following MCS and prevalence increased by 29.7%. The estimated annual percent change (EAPC) of mortality after MCS was -2.4% (95% CI: -2.9 to -2.0, P < 0.001); the EAPC of mortality associated with pneumonia after MCS was -2.2% (95% CI: -3.6 to 0.9, P = 0.01). Characteristics associated with higher odds of pneumonia included older age, male, comorbidities, nonprivate insurance, lower income, hospital volume, urban, Northeast region, and nonteaching status. Pneumonia conferred a 6.3-fold higher odd of mortality. Conclusions. Increasing prevalence of pneumonia after MCS, associated with stable mortality rates, may result from either increased diagnosis or more stringent coding. We identified characteristics associated with pneumonia after MCS which could help identify at-risk patients in order to reduce pneumonia after MCS, as it greatly increases the odds of mortality.
authors.affiliation: Departement of Pathology and Cellular Biology, University of Montreal Health Center, Montreal, QC, Canada H2X 0A9.
authors.forename: Vincent Q
authors.initials: VQ
authors.lastname: Trinh
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Praful
authors.initials: P
authors.lastname: Ravi
authors.affiliation: Center for Outcomes Research and Analytics, Henry Ford Health System, Detroit, MI 48202, USA.
authors.forename: Abd-El-Rahman M
authors.initials: AE
authors.lastname: Abd-El-Barr
authors.affiliation: Center for Outcomes Research and Analytics, Henry Ford Health System, Detroit, MI 48202, USA.
authors.forename: Jay K
authors.initials: JK
authors.lastname: Jhaveri
authors.affiliation: Division of General Surgery, University of Montreal Health Center, Montreal, QC, Canada H2X 0A9.
authors.forename: Mai-Kim
authors.initials: MK
authors.lastname: Gervais
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Urology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Meyer
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA; Department of Urology, Marien Hospital, Ruhr-University Bochum, 40479 Herne, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Hanske
authors.affiliation: Center for Outcomes Research and Analytics, Henry Ford Health System, Detroit, MI 48202, USA.
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Sammon
authors.affiliation: Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000601:surgery*; D011014:Pneumonia / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology