Identifying patients at higher risk of pneumonia after lung resection

Abstract

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.

Smoking is associated with pneumonia development in lung cancer patients

“…Clinical studies have identified several risk factors for postoperative pneumonia in lung cancer patients. Wellknown risk factors are as follows: old age (> 60 years), histopathological type of squamous cell carcinoma [4], smoking (current or previous), and the extent of excision of more than one lobe [5]. Risk factors for post bronchoscopy pneumonia in lung cancer patients are older age (> 70 years), current smoking, and central location of the tumor [6].…”

Smoking is associated with pneumonia development in lung cancer patients

“…Lee et al [14] have reported that old age is associated with the development of bacterial pneumonia in patients after cytotoxic chemotherapy in advanced lung cancer patients. Age ≥ 64 years was an independent predictors for post-operative pneumonia in lung cancer patients [5]. The elderly have several risk factors of pneumonia occurrences because of their impaired physical conditions.…”

Smoking is associated with pneumonia development in lung cancer patients

“…Wang et al [4] have demonstrated that being old aged (> 60 years) and having squamous cell carcinoma histopathological type might be important risk factors of postoperative pneumonia in lung cancer patients after surgery. Liu et al [5] have reported that patients with older age, smoking, and extent of excision of more than one lobe have a higher risk for pneumonia after lung cancer surgery.…”

“…Clinical studies have identified several risk factors for postoperative pneumonia in lung cancer patients. Well-known risk factors are as follows: old age (> 60 years), histopathological type of squamous cell carcinoma [4], smoking (current or previous), and the extent of excision of more than one lobe [5]. Risk factors for post bronchoscopy pneumonia in lung cancer patients are older age (> 70 years), current smoking, and central location of the tumor [6].…”