J Korean Med Sci.  2011 Aug;26(8):979-984. 10.3346/jkms.2011.26.8.979.

Risk Factors of Postoperative Pneumonia after Lung Cancer Surgery

• Lee JY
• Jin SM
• Lee CH
• Lee BJ
• Kang CH
• Yim JJ
• Kim YT
• Yang SC
• Yoo CG
• Han SK
• Kim JH
• Shim YS
• Kim YW

• KMID: 1777833
• DOI: http://doi.org/10.3346/jkms.2011.26.8.979

Abstract

The purpose of this study was to investigate risk factors of postoperative pneumonia (POP) after lung cancer surgery. The 417 lung cancer patients who underwent surgical resection in a tertiary referral hospital were included. Clinical, radiological and laboratory data were reviewed retrospectively. Male and female ratio was 267:150 (median age, 65 yr). The incidence of POP was 6.2% (26 of 417) and in-hospital mortality was 27% among those patients. By univariate analysis, age > or = 70 yr (P < 0.001), male sex (P = 0.002), ever-smoker (P < 0.001), anesthesia time > or = 4.2 hr (P = 0.043), intraoperative red blood cells (RBC) transfusion (P = 0.004), presence of postoperative complications other than pneumonia (P = 0.020), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 70% (P = 0.002), diffusing capacity of the lung for carbon monoxide < 80% predicted (P = 0.015) and preoperative levels of serum C-reactive protein > or = 0.15 mg/dL (P = 0.001) were related with risk of POP. Multivariate analysis showed that age > or = 70 yr (OR = 3.563, P = 0.014), intraoperative RBC transfusion (OR = 4.669, P = 0.033), the presence of postoperative complications other than pneumonia (OR = 3.032, P = 0.046), and FEV1/FVC < 70% (OR = 3.898, P = 0.011) were independent risk factors of POP. In conclusion, patients with advanced age, intraoperative RBC transfusion, postoperative complications other than pneumonia and a decreased FEV1/FVC ratio have a higher risk for pneumonia after lung cancer surgery.

Keyword

Complications; Lung Neoplasms; Pneumonia; Risk Factors; Surgery

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
C-Reactive Protein/analysis
Carbon Monoxide/metabolism
Erythrocyte Transfusion
Female
Forced Expiratory Volume
Hospital Mortality
Humans
Incidence
Logistic Models
Lung Neoplasms/pathology/*surgery
Male
Middle Aged
Neoplasm Staging
Odds Ratio
Pneumonia/epidemiology/*etiology/mortality
*Postoperative Complications
Retrospective Studies
Risk Factors
Vital Capacity

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