Factors influencing lower respiratory tract infection in older patients after general anesthesia

Abstract

Objective Pulmonary complication is common in older patients after surgery. We analyzed risk factors of lower respiratory tract infection after general anesthesia among older patients. Methods In this retrospective investigation, we included older patients who underwent surgery with general anesthesia. Logistic regression analyses were performed to determine risk factors of lower respiratory tract infection. Results A total 418 postoperative patients with general anesthesia were included; the incidence of lower respiratory tract infection was 9.33%. Ten cases were caused by gram-positive bacteria, 26 cases by gram-negative bacteria, and 2 cases by fungus. We found significant differences in age, smoking, diabetes, oral/nasal tracheal intubation, and surgery duration. Logistic regression analysis indicated that age ≥70 years (odds ratio [OR] 2.028, 95% confidence interval [CI] 1.115–3.646), smoking (OR 2.314, 95% CI 1.073–4.229), diabetes (OR 2.185, 95% CI 1.166–4.435), nasotracheal intubation (OR 3.528, 95% CI 1.104–5.074), and duration of surgery ≥180 minutes (OR 1.334, 95% CI 1.015–1.923) were independent risk factors of lower respiratory tract infections. Conclusions Older patients undergoing general anesthesia after tracheal intubation have a high risk of lower respiratory tract infections. Clinical interventions should be provided to prevent pulmonary infections in patients with relevant risk factors.

Ultrasound-guided percutaneous nephrolithotomy without indwelling ureteral catheter in older adults with upper urinary calculi: A retrospective study

“…Older patients have a long history of smoking and chronic respiratory diseases, and poor lung function, which can easily lead to postoperative pulmonary infection, [16] and the length of surgical anesthesia is one of the factors that affects postoperative pulmonary infection. [17] In the study group, the step of establishing artificial hydronephrosis was avoided, the anesthesia time of the operation was significantly shortened, and this can reduce the risk of postoperative pulmonary infection and the damage stimulation of the operation, which could speed up the postoperative recovery of the patient and reduce medical expenses.…”

The Incidence of Acute Respiratory Infection Was Higher in the Older Adults with Lower Limb Fracture Who Receive Spinal Anesthesia Than Those Who Receive General Anesthesia

“…For the surgical management of geriatric hip fractures, GA may be associated with a higher risk of acute respiratory failure relative to spinal anesthesia [ 8 ]. The aging of the immune function of older adult patients may increase their susceptibility to bacterial or virus pulmonary infection due to various pathogens [ 9 ], especially among those who are older than 70 years, have a smoking habit, have diabetes, are receiving nasotracheal intubation, and are undergoing surgery with a duration of >180 min; all these factors are independent risk factors for lower respiratory tract infection [ 10 ]. Studies in the last five years have suggested that the incidence of pneumonia in patients who undergo GA for hip fracture surgery is similar to that in patients who undergo neuraxial anesthesia for this procedure [ 5 , 8 , 11 ].…”