Post-bronchoscopy pneumonia in patients suffering from lung cancer: Development and validation of a risk prediction score

Takiguchi, Hiroto; Hayama, Naoki; Oguma, Tsuyoshi; Harada, Kazuki; Sato, Mariko; Horio, Yukihiro; Tanaka, Jun; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Takihara, Takahisa; Niimi, Kyoko; Nakagawa, Takumi; Masuda, Ryosuke; Aoki, Takuya; Urano, Tetsuya; Iwazaki, Masayuki; Asano, Koichiro

doi:10.1016/j.resinv.2016.12.007

Cited by 17 publications

(38 citation statements)

References 11 publications

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“…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 [6] have noted that the risk factors for pneumonia after bronchoscopy are old age (≥ 70 years), current smoking, and central location of the tumor. These studies were focused on pneumonia development after surgery or bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…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]. Previous studies have focused on pneumonia occurrence after surgery or bronchoscopy in lung cancer patients.…”

Section: Introductionmentioning

confidence: 99%

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Smoking is associated with pneumonia development in lung cancer patients

et al. 2020

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Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non-pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019-1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004-3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562-4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100-3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012-1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826-5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071-4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Smoking is associated with pneumonia development in lung cancer patients

et al. 2020

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“…Takiguchi et al [6] have noted that the risk factors for pneumonia after bronchoscopy are old age (≥ 70 years), current smoking, and central location of the tumor. These studies were focused on pneumonia development after surgery or bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…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]. Previous studies have focused on pneumonia occurrence after surgery or bronchoscopy in lung cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Smoking is associated with pneumonia development in lung cancer patients

Heo

Yeo

Park

et al. 2020

Preprint

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Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.

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“…Although it is a relatively safe procedure, transbronchial biopsy (TBB) can rarely be complicated by several postbronchoscopic adverse events, such as fever, pneumonia, infection at the biopsied site, hemorrhage, or pneumothorax. 3 Among these events, infectious complications after TBB constitute a serious clinical problem because they might delay the start of treatment or cause the intended treatment to be modified to a milder one. The precise mechanism of such complications is still unclear, and effective prophylaxis procedures have not been established.…”

mentioning

confidence: 99%