Risk factors and outcomes of postoperative pneumonia in non-small cell lung cancer patients undergoing bronchoplasty: findings from a retrospective cohort study in a large-volume center in China

Abstract

Background Postoperative pneumonia (POP) is one of the most common severe complications after lung cancer surgery. Few studies have investigated the risk factors associated with POP in patients who underwent bronchoplasty. This study aimed to identify the risk factors for POP after bronchoplasty in lung cancer patients. Methods A single-center retrospective cohort study with the inclusion of all the lung cancer patients who underwent bronchoplasty from September 2005 to August 2020 was conducted. Data on these patients were acquired from Western China Lung Cancer Database, which collected demographic characteristics, perioperative data, postoperative complications, and follow-up information on patients. Univariate and multivariable analyses were used to identify risk factors for POP. In addition, the length of postoperative stay and 30-day mortality associated with POP were analyzed. Results A total of 408 patients were identified. The prevalence of POP was 15%. Multivariable analysis showed that age ≥65 years [odds ratio (OR) =2.661, 95% confidence interval (CI): 1.388–5.120, P=0.003], surgical duration (OR =1.185, 95% CI: 1.040–1.351, P=0.01), and pulmonary artery angioplasty (OR =2.164, 95% CI: 1.190–3.937, P=0.01) were independent risk factors for POP after bronchoplasty. Patients with POP had prolonged hospital stay (P<0.001) and higher mortality rate (P<0.001). Conclusions Advanced age, prolonged surgical duration, and pulmonary artery angioplasty were important factors associated with POP in the lung cancer patients who underwent bronchoplasty. And POP is associated with poor outcomes. Surgeons should pay more attention to these patients with risk factors and intervene early to prevent serious outcomes.