title: Risk factors for morbidities and mortality in children following pneumonectomy.
abstract: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized.
  
  
  
  In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities. Scoliosis, wound infection and atelectasis were considered minor morbidities.
  
  
  
  Median age at PNE was 7.4 years; 45% were males. Indications of pneumonectomy were postinfectious bronchiectasis (61%), tumours (17%), pulmonary malformations (17%), aspiration syndrome (14%), cystic fibrosis (6%), immunodeficiency (4%) and trauma (2%). Mortality rate was 4% at 1 month. Major and minor morbidities were present in 23% and 27% of patients, respectively. Risk factors for development of morbidities after PNE were age ≤ 3 years (OR: 16.7; 95% CI: 2.4-117) and the need for mechanical ventilation for at least 4 days (OR: 8; 95% CI: 1.5-43.6).
  
  
  
  Children are at high risk of death, major and minor morbidities following PNE. Caution is recommended for this group of patients.
authors: Pulmonology Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Verónica
authors: V
authors: Giubergia
authors: Pulmonology Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Florencia
authors: F
authors: Alessandrini
authors: Pulmonology Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Carolina
authors: C
authors: Barrias
authors: General Surgery Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Carlos
authors: C
authors: Giuseppucci
authors: General Surgery Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Aixa
authors: A
authors: Reusmann
authors: General Surgery Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Marcelo
authors: M
authors: Barrenechea
authors: Pulmonology Department, Prof. Dr. Juan P. Garrahan Pediatric Hospital, Buenos Aires, Argentina.
authors: Claudio
authors: C
authors: Castaños
mesh_terms: D001118:Argentina / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011030:Pneumothorax / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
keywords: children; morbidity; mortality; pneumonectomy; risk factors