Risk Factors of Postoperative Respiratory Infections in Lung Cancer Surgery

Shiono, Satoshi; Yoshida, Junji; Nishimura, Mitsuyo; Hagiwara, Masaru; Hishida, Tomoyuki; Nitadori, Jun-ichi; Nagai, Kanji

doi:10.1097/jto.0b013e31802bafb6

Cited by 59 publications

(66 citation statements)

References 17 publications

(22 reference statements)

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“…Similar to our study, Iwamoto et al found that patients older than 65 years who underwent thoracic surgery were associated with the highest incidence of pneumonia (10). Shiono et al reported that age older than 75 years was an independent significant risk factor for POP (8). However, the observation of increased POP risk with advanced age showed contrary to the findings to the Schussler et al study (14).…”

Section: Discussioncontrasting

confidence: 56%

“…However, statistical significance was not observed (P>0.05) in multivariate analyses. The observation of our study was consistent with the findings of some reports (6,7), while disagreed with the findings of Shiono et al (8), which confirmed an increased risk of POP for cancer stages ≥III compared to stages I/II. Although statistical significance was not reached, we could still find the proportion of patients with POP in stages II/ III to be higher than stages I.…”

Section: Discussioncontrasting

confidence: 41%

“…Postoperative pneumonia (POP) is one of the most frequent complications following thoracic surgery and is strongly associated with high mortality rates (2,3). Many perioperative risk factors have been reported to be associated with an increased incidence of pneumonia after surgery (2,(4)(5)(6)(7)(8). However, there was no specific scoring system constructed to date for the prediction of POP after lung resection.…”

Section: Introductionmentioning

confidence: 99%

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Identifying patients at higher risk of pneumonia after lung resection

et al. 2017

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Background: Pneumonia is considered as one of the most common and serious complications after lung resection. The purpose of this study was to identify the risk factors associated with postoperative pneumonia (POP) after lung resection and to develop a scoring system to stratify patients with increased risk of POP.Methods: A retrospective review of a prospective database of patients between September 2014 and June 2016 was carried out. Logistic regression analysis was used to examine the risk factors for POP. Bootstrap resampling analysis was used for internal validation. Regression coefficients were used to develop weighted risk scores for POP.Results: Results revealed that age ≥64 years, smoking (current or previous), high pathological stage, and extent of excision of more than one lobe as risk factors. Logistic regression analysis showed that the predictors of POP were as follows: age ≥64 years, smoking, extent of excision of more than one lobe.A weighted score based on these factors was developed which was follows: smoking (three points), age ≥64 years (four points), and extent of excision of more than one lobe (five points). POP score >5 points offered the best combination of sensitivity (64.7%) and specificity (83.3%), and an area under receiver operating characteristic (ROC) curve ( Conclusions: Patients with older age, smoking and extent of excision of more than one lobe have a higher risk for pneumonia after lung cancer surgery. Also, the scoring system helps to guide decision making of POP risk reduction.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussioncontrasting

confidence: 41%

Section: Introductionmentioning

confidence: 99%

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Identifying patients at higher risk of pneumonia after lung resection

et al. 2017

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“…However, this result has given rise to new questions: did prolongation of the drainage duration lead to empyema, or was drainage duration prolonged because of the development of empyema? Shiono et al reported that advanced age was a risk factor in development of empyema [17]. Although no statistical significance was found in analysis of the age factor, empyema development was more common in elderly cases.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors in Development of Postoperative Empyema

Özkan¹

2014

Ann Clin Anal Med

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Anahtar KelimelerAmpiyem; Risk Faktörleri; Postoperatif Abstract Aim: Many etiological factors play a role in the occurrence of postoperative empyema. We aimed to define the effects of these factors on the development of empyema. Material and Method: Two hundred and eighty-eight cases from our clinic who underwent tube thoracostomy and/or were operated due to any cause out of the primary empyema between August 2009 and May 2010 were prospectively studied in terms of empyema development. Data comprised gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, sharing the same room with other cases with empyema, primary disease, additional comorbidity, operation duration, drain number, complication, number of patients in the room, and drain discontinuation and hospitalization duration. Blood leukocyte-neutrophil count was ordered in all cases at 3-day intervals, and fluid culture specimens were simultaneously collected from cases with drains. Drainage fluid culture specimens were evaluated with "Automated Identification and Antibiotic Susceptibility Testing" using standard procedures. Empyema cases who developed clinical manifestation and/or with bacterial growth in culture specimens were studied in terms of risk factors. The findings were analyzed using SPSS (version 16). Results: The results showed that gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, and sharing a same room with other empyema cases were not significantly correlated with the risk of empyema development. Contribution of the primary disease (p<0.05), additional comorbidity (p<0.05), operation duration (p<0.05), drain number (p<0.05), complication (p<0.05), number of people in the room (p<0.05), drain discontinuation time (p<0.05) and hospitalization duration (p<0.05) were found to be significant in the development of postoperative empyema. Discussion: Postoperative development of empyema is one of the most serious problems encountered in patients who have undergone tube thoracostomy. Therefore, current risks should be thoroughly assessed in the preoperative period and approaches to minimize these risks should be adopted.

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“…Our work showed that ages, lymphocyte counts, smoking histories, histories of chronic bronchitis, operation modes and postoperative extubation time were significantly associated with pulmonary infection. Schussler (9) determined that postoperative pneumonia after lung resection developed in 25% of patients, and others also have demonstrated that elderly patients tend to develop respiratory infections after thoracic surgery (11,12). It was demonstrated, by multivariate analysis, that lung cancer patients of advanced ages, in particular those 75 years of age and older, was a high-risk group for postoperative pneumonia (12).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

Gao

et al. 2017

J. Thorac. Dis.

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Background: Postoperative cardiopulmonary complications might be fatal for patients with lung cancer after surgery. The aim of this study was to identify the risk factors of postoperative cardiopulmonary complications in lung cancer patients and get a fitting formula for predicting incidences of cardiopulmonary complications. Methods:We conducted a retrospective analysis of 653 patients with a diagnosis of lung cancer who underwent a surgery in the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) from January to December 2014. All patients received lung cancer surgeries. Clinical data was collected for the analysis of the influence factors of cardiopulmonary complication after lung cancer surgeries. The medical statistical analysis program R was used to calculate cardiopulmonary complication probability of classification of quantitative results.Results: Our work showed that ages, lymphocyte count, smoking history, chronic bronchitis history, operation mode and extubation time were significantly associated with lung infection both in univariate and multivariate survival analysis. And ages, smoking history, arrhythmia of electrocardiogram and operation mode were significantly associated with postoperative arrhythmia both in univariate and multivariate survival analysis. Multiple linear regressions were generated with risk factors by program R software. Finally, we got a fitting formula for predicting cardiopulmonary complications. Risk score for each patient could be obtained by this formula. Conclusions:The incidences of pulmonary infection and arrhythmia were high for patients who underwent lung cancer surgery. It is important to discriminate risk factors for each patient for reducing the risk of heart and lung complications. Preoperative quantitative evaluation of cardiopulmonary complication after operation is beneficial to the risk control.

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Risk Factors of Postoperative Respiratory Infections in Lung Cancer Surgery

Abstract: Lung cancer patients with advanced age, low FEV1%, advanced pathologic stage, or induction therapy had a risk for pneumonia after lung cancer surgery. Postoperative empyema was associated with advanced age.

Cited by 59 publications

References 17 publications

Identifying patients at higher risk of pneumonia after lung resection

Identifying patients at higher risk of pneumonia after lung resection

Risk Factors in Development of Postoperative Empyema

Analysis of the risk factors of postoperative cardiopulmonary complications and ability to predicate the risk in patients after lung cancer surgery

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