Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia

Abstract

2 Highlights-Postoperative aspiration pneumonia is a rare complication, however, remains a severe disease with a significant mortality of 27% in this series.-Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia.-The identification of those patients at increased risk for death after aspiration may help to further improve patients outcome. Conclusion: Postoperative aspiration pneumonia remains a severe complication with significant mortality. Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia. Therefore, these patients suffering aspiration pneumonia require special attention and increased monitoring.

The Epidemiology and Risk Factors for Postoperative Pneumonia

“…Pasin et al [28] conducted a systematic review and meta-analysis of 269,637 patients who had open abdominal aortic surgery, with an incidence for postoperative pulmonary complications of 10.3%, where pneumonia was the most frequently reported at 7.30%. A retrospective study by Studer et al [29] outlined 70 abdominal surgery patients who developed postoperative aspiration pneumonia, and had a mortality rate of 27%. Yang et al [30] retrospectively reviewed 165,196 patients after undergoing abdominal surgery, who had a postoperative pneumonia incidence of 3.2%.…”

“…Kim et al [27] found severe COPD was a risk factor for postoperative pneumonia (OR: 3.47; 95% CI: 1.16 - 10.42; P = 0.027), as well as a history of hospitalization for respiratory problems (OR: 4.20; 95% CI: 1.52 - 11.59; P = 0.006), emergency surgery (OR: 3.93; 95% CI: 1.75 - 8.82; P = 0.001), amount of RBC transfusion (OR: 1.09; 95% CI: 1.05 - 1.14; P < 0.001 for one pack increase of red blood cell (RBC) transfusion), and laparoscopic surgery (OR: 0.41; 95% CI: 0.18 - 0.93; P = 0.033). The risk factors for mortality from postoperative pneumonia identified by Studer et al [29] were older age (OR: 7.41; 95% CI: 1.29 - 42.62), bilateral aspiration pneumonia (OR: 7.39; 95% CI: 1.86 - 29.29), and intraoperative blood transfusion (OR: 5.09; 95% CI: 1.34 - 19.38). Yang et al [30] found the strongest risk factors for developing pulmonary complications were esophageal operations and American Society of Anesthesiology (ASA) class.…”

Prevalence and in-hospital outcome of aspiration in out-of-hospital intubated trauma patients

“…Possible complications after aspiration are airway obstruction, Mendelson's syndrome, pneumonia, or acute respiratory distress syndrome (ARDS), which are associated with prolonged ventilator weaning, ICU stay, and increased mortality [12][13][14].…”

Abstract Journal General Surgery

“…The Ambu ® aScope™ is the most versatile instrument for surgeons 'sharing advanced airway devices' as it can be used in bronchoscopy, peri-operative vocal cord assessment in thyroidectomy [1] and laparoscopic common bile duct exploration [2], these have been used at our institution.…”

“…Death due to aspiration is considered uncommon but has a mortality rate up to 30% (Studer et al, 2016). We aim to provide an overview of patients who died due to aspiration across all surgical specialties in Australia.…”