Predicting and Managing Postoperative Pneumonia in Thoracic Surgery Patients: The Role of Age, Cancer Type, and Risk Factors

Run-Ze Li; Lin-Lin Cai; Wen-Wen Hu; Li-Rong Lian; Wei-Yu  Meng; Jun Zhang; Jia-long Guo; Xiao-Jun Yao; Hu-Dan Pan; Liang Liu; Yi-Jun Tang; Elaine Lai-Han Leung

doi:10.37155/2972-4759-2023-01-01-7

Authors

Run-Ze Li State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Lin-Lin Cai Respiratory Medicine Department of Taihe Hospital, Hubei University of Medicine, Hubei, China
Wen-Wen Hu Respiratory Medicine Department of Taihe Hospital, Hubei University of Medicine, Hubei, China
Li-Rong Lian State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Wei-Yu Meng Faculty of Applied Science, Macao Polytechnic University, Macao, China.
Jun Zhang Department of Cardiothoracic Surgery, Taihe Hospital, Hubei University of Medicine, Hubei, China
Jia-long Guo Department of Cardiothoracic Surgery, Taihe Hospital, Hubei University of Medicine, Hubei, China
Xiao-Jun Yao State Key Laboratory of Quality Research in Chinese Medicine/Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Macau (SAR), China
Hu-Dan Pan State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Liang Liu State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Yi-Jun Tang Respiratory Medicine Department of Taihe Hospital, Hubei University of Medicine, Hubei, China
Elaine Lai-Han Leung Cancer Center, Faculty of Health Sciences, University of Macau, Macau (SAR), China. MOE Frontiers Science Center for Precision Oncology, University of Macau, Macau (SAR), China

DOI:

https://doi.org/10.37155/2972-4759-2023-01-01-7

Keywords:

Postoperative pulmonary infection, thoracic surgery, cancer, age, biomarkers

Abstract

Postoperative pulmonary infection (PPI) is of high incidence in cancer patients undergoing thoracic surgery. However, the main pneumonia risk factors and a patient-specific predictive model are still lacking. This study aimed to investigate the impact of age, cancer type, and various risk factors on the development of postoperative pneumonia in thoracic surgery patients. A total of 231 patients who underwent thoracic surgery were included. The analysis revealed that male patients, patients aged ≥65 years, and those with a smoking history or chronic obstructive pulmonary disease (COPD) were significantly more likely to develop postoperative pneumonia. In contrast, diabetes and hypertension were not identified as risk factors. Patients with longer intubation times, peri-operative bleeding, hospitalization times, and operating times were also more likely to develop postoperative pneumonia. Interestingly, preoperative therapies such as antibiotic use and aerosol inhalation did not show significant benefits in reducing postoperative pneumonia incidence. Hematology tests revealed that low preoperative albumin (pre-ALB) levels and other specific markers were potential indicators of postoperative pneumonia. Binary logistic regression analysis identified pulmonary function, intubation time, intraoperative bleeding, pre-ALB after operation, and preoperative hospital stay as significant risk factors. A risk model formula was constructed and validated, demonstrating successful model construction. The results highlight the importance of considering patient age, cancer type, and various risk factors in predicting and managing postoperative pneumonia in thoracic surgery patients.

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