Risk factors of postoperative nosocomial pneumonia after resection of bronchogenic carcinoma

SummaryBackgroundPostoperative pneumonia following resection of bronchogenic carcinoma is a severe complication with a high rate of morbidity and mortality. The objective of this study is to determine the clinical and epidemiologic characteristics and the risk factors of postoperative pneumonia in patients undergoing resection of bronchogenic carcinoma in a third-level university hospital.MethodsWe performed a study of cases (with postoperative pneumonia) and controls (without pneumonia) nested in a prospective cohort of 604 patients who had undergone surgery for bronchogenic carcinoma in clinical stages I–IIIa between January 1999 and June 2004, where each case was grouped with 3 controls (3:1) of the same age (±5 years) and cancer staging by means of TNM classification.ResultsThe incidence of postoperative pneumonia was 22 cases (3.6%). Overall in-hospital mortality of patients who underwent resection of bronchogenic carcinoma was 32 patients (5.3%). In-hospital mortality due to postoperative pneumonia was 7 cases (31.8%). In the postoperative pneumonia group, microorganisms were isolated in 10 cases (45.5%). The following factors appear in the multivariate analysis as statistically significant independent risk factors for postoperative pneumonia: body mass index <26.5 kg/m2 (adjusted odds-ratio (OR) per unit 0.64, 95% confidence interval (CI) 0.45–0.90, p = 0.011), predicted postoperative FEV1 <50% pred. (adj. OR per unit 0.92, 95% CI 0.85–0.99, p = 0.037), and reintubation after surgery (adj. OR 18.1, 95% CI 1.3–256.6, p = 0.032).ConclusionsIdentifying the risk factors (some of which can by modified by medical intervention) may improve the course of lung cancer treated with surgery.