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Risk Factors of Postoperative Nosocomial Pneumonia in Stage I-IIIa Lung Cancer Patients

  • Wang, Zeng (Department of pharmacy, Zhejiang cancer hospital) ;
  • Cai, Xin-Jun (Department of pharmacy, Integrated Chinese and Western Medicine Hospital of Zhejiang Province) ;
  • Shi, Liang (Department of pharmacy, Zhejiang cancer hospital) ;
  • Li, Fei-Yan (Department of Good Clinical Practice, Zhejiang cancer hospital) ;
  • Lin, Neng-Ming (Department of pharmacy, Zhejiang cancer hospital)
  • Published : 2014.04.01

Abstract

Background: To investigate the related risk factors of postoperative nosocomial pneumonia (POP) in patients withI-IIIa lung cancer. Methods: Medical records of 511 patients who underwent resection for lung cancer between January 2012 to December 2012 were retrospectively reviewed. Risk factors of postoperative pneumonia were identified and evaluated by univariate and multivariate analyses. Results: The incidence of postoperative pneumonia in these lung cancer patients was 2.9% (15 cases). Compared with 496 patients who had no pneumonia infection after operation, older age (>60), histopathological type of squamous cell carcinoma and longer surgery time (>3h) were significant risk factors by univariate analysis. Other potential risk factors such as alcohol consumption, history of smoking, hypersensitivity, hypertension, diabetes mellitus and so on were not showed such significance in this study. Further, the multivariate analysis revealed that old age (>60 years) (OR 5.813, p=0.018) and histopathological type of squamous cell carcinoma (OR 5.831, p<0.001) were also statistically significant independent risk factors for postoperative pneumonia. Conclusions: This study demonstrated that being old aged (>60 years) and having squamous cell carcinoma histopathological type might be important factors in determining the risk of postoperative pneumonia in lung cancer patients after surgery.

Keywords

Risk factor;postoperative pneumonia;lung cancer

References

  1. Wada H, Nakamura T, Nakamoto K, et al (1998). Thirty-day operative mortality for thoracotomy in lung cancer. J Thorac Cardiovasc Surg, 115, 70-3. https://doi.org/10.1016/S0022-5223(98)70444-1
  2. Shiono S, Yoshida J, Nishimura M, et al (2007). Risk factors of postoperative respiratory infections in lung cancer surgery. J Thorac Oncol, 2, 34-8. https://doi.org/10.1097/JTO.0b013e31802bafb6
  3. Sogaard M, Thomsen RW, Bossen KS, et al (2013). The impact of comorbidity on cancer survival: a review. Clin Epidemiol, 5, 3-29.
  4. Stephan F, Boucheseiche S, Hollande J, et al (2000). Pulmonary complications following lung resectiona comprehensive analysis of incidence and possible risk factors. Chest, 118, 1263-70. https://doi.org/10.1378/chest.118.5.1263
  5. Yamada Y, Sekine Y, Suzuki H, et al (2010). Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg, 37, 752-7. https://doi.org/10.1016/j.ejcts.2009.05.039
  6. Ogawa F, Wang G, Matsui Y, et al (2013). Risk factors for postoperative complications in the elderly with lung cancer. Asian Cardiovasc Thorac Ann, 21, 313-8. https://doi.org/10.1177/0218492312457359
  7. Jagoe RT, Goodship TH, Gibson GJ (2001). The influence of nutritional status on complications after operations for lung cancer. Ann Thorac Surg, 71, 936-43. https://doi.org/10.1016/S0003-4975(00)02006-3
  8. Kyriazi V, Theodoulou E (2013). Assessing the risk and prognosis of thrombotic complications in cancer patients. Arch Pathol Lab Med, 137, 1286-95. https://doi.org/10.5858/arpa.2012-0490-RA
  9. Lee JY, Jin S-M, Lee C-H, et al (2011). Risk factors of postoperative pneumonia after lung cancer surgery. J Korean Med Sci, 26, 979-84. https://doi.org/10.3346/jkms.2011.26.8.979
  10. Rivera C, Falcoz P-E, Bernard A, et al (2011). Surgical management and outcomes of elderly patients with early stage non-small cell lung cancerlung cancer in the elderly: postoperative outcomes a nested case-control study. Chest, 140, 874-80. https://doi.org/10.1378/chest.10-2841
  11. Schussler O, Alifano M, Dermine H, et al (2006). Postoperative pneumonia after major lung resection. Am J Respir Crit Care Med, 173, 1161-9. https://doi.org/10.1164/rccm.200510-1556OC
  12. Seok Y, Hong N, Lee E (2013). Impact of smoking history on postoperative pulmonary complications: a review of recent lung cancer patients. Ann Thorac Cardiovasc Surg. [Epub ahead of print]
  13. Seok Y, Lee E, Cho S (2012). Respiratory complications during mid-and long-term follow-up periods in patients who underwent pneumonectomy for non-small cell lung cancer. Ann Thorac Cardiovasc Surg, 19, 335-40.
  14. Sekine Y, Suzuki H, Yamada Y, et al (2013). Severity of chronic obstructive pulmonary disease and its relationship to lung cancer prognosis after surgical resection. Thorac Cardiovasc Surg, 61, 124-30.
  15. Shiono S, Abiko M, Sato T (2013). Postoperative complications in elderly patients after lung cancer surgery. Interact Cardiovasc Thorac Surg, 16, 819-23. https://doi.org/10.1093/icvts/ivt034
  16. D'Journo XB, Rolain JM, Doddoli C, et al (2011). Airways colonizations in patients undergoing lung cancer surgery. Eur J Cardiothorac Surg, 40, 309-19.
  17. Aoki T, Yamato Y, Tsuchida M, et al (2000). Pulmonary complications after surgical treatment of lung cancer in octogenarians. Eur J Cardiothorac Surg, 18, 662-5. https://doi.org/10.1016/S1010-7940(00)00573-X
  18. Arozullah AM, Khuri SF, Henderson WG, Daley J (2001). Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med, 135, 847-57. https://doi.org/10.7326/0003-4819-135-10-200111200-00005
  19. Belda J, Cavalcanti M, Ferrer M, et al (2005). Bronchial colonization and postoperative respiratory infections in patients undergoing lung cancer surgery. Chest, 128, 1571-9. https://doi.org/10.1378/chest.128.3.1571
  20. Diaz-Ravetllat V, Ferrer M, Gimferrer-Garolera JM, et al (2012). Risk factors of postoperative nosocomial pneumonia after resection of bronchogenic carcinoma. Respir Med, 106, 1463-71. https://doi.org/10.1016/j.rmed.2012.07.008
  21. Dirican N, Baysak A, Cok G, et al (2013). Clinical characteristics of patients with bronchioloalveolar carcinoma: a retrospective study of 44 cases. Asian Pac J Cancer Prev, 14, 4365-8. https://doi.org/10.7314/APJCP.2013.14.7.4365
  22. Eliasen M, Gronkjaer M, Skov-Ettrup LS, et al (2013). Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis. Ann Surg, 258, 930-42 https://doi.org/10.1097/SLA.0b013e3182988d59
  23. Ferdinand B, Shennib H (1998). Postoperative pneumonia. Chest Surg Clin N Am, 8, 529-39.
  24. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  25. Gupta H, Gupta PK, Schuller D, et al (2013). Development and validation of a risk calculator for predicting postoperative pneumonia. Mayo Clin Proc, 88, 1241-9. https://doi.org/10.1016/j.mayocp.2013.06.027
  26. Abidoye O, Ferguson MK, Salgia R (2007). Lung carcinoma in African Americans. Nat Clin Pract Oncol, 4, 118-29.
  27. Agostini P, Cieslik H, Rathinam S, et al (2010). Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax, 65, 815-8. https://doi.org/10.1136/thx.2009.123083
  28. Alifano M, Regnard J-F (2010). Postoperative pneumonia in lung cancer patients: chronic obstructive pulmonary disease, preoperative bronchial colonisation and antibioprophylaxis are critical issues. Eur J Cardiothorac Surg, 37, 750-1. https://doi.org/10.1016/j.ejcts.2009.10.013

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