Abstract
BackgroundVideo-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.MethodsA 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.ResultsThe 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).ConclusionsMajor 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.
Highlights
Lung resection is the main treatment for benign and malignant pulmonary tumours [1, 2]
body mass index (BMI), BMI grading, forced vital capacity, surgical lobe, intraoperative bleeding, total intravenous crystalloid infusion in the postoperative 24 h and total intravenous crystalloid infusion grading in the postoperative 24 h were significantly different between Postoperative pneumonia (POP) and no-POP groups (Tables 1)
Binary logistics regression analysis demonstrated that BMI grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL were independent risk factors of POP after video-assisted thoracoscopic surgery (VATS) lobectomy (Table 3)
Summary
Lung resection is the main treatment for benign and malignant pulmonary tumours [1, 2]. Postoperative pneumonia (POP) is one of the most common complications and the main cause of death in patients undergoing lung resection [3,4,5,6]. Yang et al Journal of Cardiothoracic Surgery (2019) 14:209 perioperative period, and targeting perioperative interventions in patients at high risk of POP may decrease POP frequency and mortality. The objectives of this single-centre observational retrospective study were to identify risk factors for POP after VATS lobectomy and provide a reference for clinical prevention of POP. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy
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