Risk Factors for Postoperative Pneumonia: The Importance of Protein Depletion

Abstract Hypoalbuminemia is associatied with poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on complications in patients undergoing brain tumor surgery. This retrospective study included 372 consecutive patients who underwent brain tumors surgery from January 2017 to December 2019. The patients were divided into hypoalbuminemia (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L) based on postoperative albumin levels. Logistic regression analyses were used to determine risk factors. Of the total 372 patients, 333 (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). Postoperative pneumonia had a higher incidence in patients with than without hypoalbuminemia (41.1% vs 23.1%, P = 0.029). The independent predictors of postoperative pneumonia were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and is associated with postoperative pneumonia in patients undergoing brain tumor surgery.

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Risk factors for extended length of stay following hip fracture surgery: A retrospective cohort study of patients aged 90 years and over in China

10.21203/rs.2.12969/v1 ◽

2019 ◽

Author(s):

Ling Lan ◽

Li-jian Pei ◽

Feifei Zhai ◽

Yuelun Zhang ◽

Jun Jing ◽

...

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Retrospective Cohort ◽

Binary Logistic Regression ◽

Postoperative Pneumonia ◽

Binary Logistic Regression Analysis ◽

Hip Fracture Surgery ◽

Extended Length ◽

Potential Risk Factors ◽

Fracture Surgery

Abstract Background Hip fractures are typical fractures in geriatric patients and are associated with a high risk of postoperative complications and extended length of stay (LOS) compared with other osteoporotic fractures, particularly among patients over age 90. We aimed to identify the risk factors for extended LOS (more than 14 days) in patients older than 90 years. Methods A single-centre retrospective cohort study was performed in 50 patients (over age 90) who experienced hip fracture between June 1, 2013, and August 31, 2017. Their medical records were retrospectively reviewed from the hospital’s electronic database. The baseline characteristics of the patients, intraoperative data and postoperative complications were collected for the assessment of potential risk factors. Univariate analysis and multivariate binary logistic regression analysis were performed to determine potential risk factors for extended LOS. Results The age of the patients in the cohort ranged from 90 to 101 years, and the analysis demonstrated that 70% (n = 35) of the patients experienced a complicated course of treatment with an in-hospital mortality rate of 4% (n = 2). The most common complication was the occurrence of postoperative pneumonia (38%). The median duration of hospital stay was 18 (IQR 11, 21) days. Multivariate binary logistic regression analysis showed that a LOS of more than 14 days was significantly associated with a lower mean diastolic blood pressure during surgery [odds ratio (OR) =0.86, 95% confidence interval (CI)=0.76-0.98, P = 0.018] and the occurrence of postoperative pneumonia (OR=8.95, 95% CI=1.45-55.3, P = 0.018). The occurrence of postoperative pneumonia was significantly associated with the neutrophil-to-lymphocyte ratio (NLR) at admission (D0) [odds ratio (OR) =1.20, 95% confidence interval (CI)=1.02-1.41, P = 0.029]. Neither the LOS nor postoperative pneumonia was found to be associated with the anaesthesia technique. Conclusions A lower mean diastolic blood pressure during surgery and the occurrence of postoperative pneumonia may extend the LOS in patients aged 90 years and over who undergo hip fracture surgery. The use of regional anaesthesia was not associated with a shorter LOS.

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Surveillance of bacterial airway colonization during general anesthesia does not predict postoperative pneumonia in lung cancer patients after pulmonary resection: A retrospective analysis of risk factors

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.28.557 ◽

2014 ◽

Vol 28 (5) ◽

pp. 557-563

Author(s):

Teruaki Mizobuchi ◽

Takamasa Yun ◽

Hidemi Suzuki ◽

Terunaga Inage ◽

Takayoshi Yamamoto ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

General Anesthesia ◽

Retrospective Analysis ◽

Cancer Patients ◽

Pulmonary Resection ◽

Postoperative Pneumonia ◽

Lung Cancer Patients ◽

Airway Colonization

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Incidence and Risk Factors of Postoperative Pneumonia in Abdominal Operations Patients at a Teaching Hospital in China

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2017.272 ◽

2018 ◽

Vol 39 (4) ◽

pp. 504-506

Author(s):

Bizhen Chen ◽

Yuhua Chen ◽

Chunhui Li ◽

Xun Huang ◽

Pengcheng Zhou ◽

...

Keyword(s):

Risk Factors ◽

Teaching Hospital ◽

Postoperative Pneumonia ◽

Abdominal Operations

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Incidence And Risk Factors For Postoperative Pneumonia Following Surgically Treated Hip Fracture In Geriatric Patients: A Retrospective Cohort Study

10.21203/rs.3.rs-1115522/v1 ◽

2021 ◽

Author(s):

Yunxu Tian ◽

Yanbin Zhu ◽

Kexin Zhang ◽

Miao Tian ◽

Shuhui Qin ◽

...

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Geriatric Patients ◽

Multivariate Analyses ◽

Postoperative Pneumonia ◽

Multivariate Logistic Regression Model ◽

Preventive Strategy ◽

Tertiary Referral Center ◽

Independent Risk Factors ◽

Clinical Conditions

Abstract Objective: Large sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.Methods: A retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.Results: This study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.7%. In the multivariate analyses, age (OR, 1.04; 95% CI, 1.02–1.06), sex (males) (OR, 2.27; 95% CI, 1.64-3.13), respiratory disease (OR, 3.74; 95% CI, 2.32–6.04), heart disease (OR, 1.68; 95% CI, 1.14–2.47), cerebrovascular disease (OR, 1.58; 95% CI, 1.11–2.27), liver disease (OR, 2.61; 95% CI, 1.33–5.15), preoperative stay (OR, 1.08; 95% CI, 1.05–1.11) and general anesthesia (OR, 1.61; 95% CI, 1.15-2.27) were identified as independent risk factors for postoperative pneumonia.Conclusions: This study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reductionof postoperative pneumonia.

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PS01.131: POSTOPERATIVE ANASTOMOTIC LEAKAGE AND PNEUMONIA FOLLOWING ESOPHAGECTOMY: A RETROSPECTIVE SINGLE-CENTER ANALYSIS

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.131 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 87-87

Author(s):

Jonas Herzberg ◽

Tim Strate ◽

Human Honarpisheh

Keyword(s):

Risk Factors ◽

Anastomotic Leakage ◽

Protein Level ◽

Conflicts Of Interest ◽

Postoperative Outcome ◽

Postoperative Pneumonia ◽

P Value ◽

Intraoperative Bleeding ◽

Perioperative Nutrition ◽

Median Operative Time

Abstract Background Anastomotic leakage and pneumonia following esophagectomy remain a significant clinical challenge and contribute to the postoperative outcome. Aim of this study was to investigate the relation between risk factors for the occurrence of leakage or pneumonia and the postoperative outcome and to identify further risk factors. Methods We analyzed 53 consecutive patients who underwent a surgical resection of the esophagus (distal esophagectomy and abdominothoracical esophagectomy) from January 2015 until August 2017. Patients demographics, perioperative parameters, and postoperative events were analyzed. Patient data were expressed as mean ± SD (range). P < 0.05 was considered statistically significant. Results Postoperative pneumonia and anastomotic leakage occurred in 15 (28%) and 8 (15%) patients, respectively. Median operative time was 330.7 (± 69.6) minutes, and median length of stay was 24.8 (± 10.6) days. 2 (3.8%) of the patients required blood transfusion due to intraoperative bleeding. BMI, ASA-score, and an intraoperative performed lymphadenectomy did not affect the occurrence of pneumonia or anastomotic leakage. Patients with anastomotic leakage stayed longer at the ICU. However, the overall hospitalization rate did not differ significantly. As an independent risk factor, we identified that hypoproteinaemia with a protein level ≤ 5 g/dl (p-value 0.036) leads to a significant higher occurrence of anastomotic leakage. We could not identify any risk factors with regards to postoperative pneumonia. Conclusion The prevalence of hypoproteinaemia in patients after esophagectomy was associated with a higher occurrence of postoperative anastomotic leakage. These results indicate the importance of the perioperative nutrition aiming for a balanced protein level irrespective of comorbidity and surgical procedure. Disclosure All authors have declared no conflicts of interest.

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Risk factors for postoperative pneumonia according to examination findings before surgery under general anesthesia

Clinical Oral Investigations ◽

10.1007/s00784-020-03230-7 ◽

2020 ◽

Vol 24 (10) ◽

pp. 3577-3585 ◽

Cited By ~ 3

Author(s):

Yuko Inai ◽

Yoshiaki Nomura ◽

Tohru Takarada ◽

Nobuhiro Hanada ◽

Naohisa Wada

Keyword(s):

Risk Factors ◽

General Anesthesia ◽

Postoperative Pneumonia

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Excessive intravenous crystalloid infusion after video-assisted thoracoscopic surgery lobectomy is associated with postoperative pneumonia

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1024-6 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Rong Yang ◽

Chengli Du ◽

Jinming Xu ◽

Linpeng Yao ◽

Siying Zhang ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Confidence Interval ◽

Odds Ratio ◽

Thoracoscopic Surgery ◽

Postoperative Pneumonia ◽

Lung Lobe ◽

Video Assisted ◽

Crystalloid Infusion ◽

Video Assisted Thoracoscopic Surgery

Abstract Background Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy. Methods A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017–04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy. Results The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m2 (vs. <24.0 kg/m2: odds ratio 1.904, 95% confidence interval 1.294–2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216–2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302–3.260, P = 0.002). Conclusions Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.

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