Risk factors for postoperative pneumonia after gastrectomy for gastric cancer

Surg Today. 2016 May;46(5):552-6. doi: 10.1007/s00595-015-1201-8. Epub 2015 Jun 16.

Abstract

Purpose: The number of elderly patients undergoing gastrectomy for gastric cancer is increasing. Yet, although elderly patients are at high risk of postoperative pneumonia, no study has sufficiently investigated which clinicopathological factors are significant risk factors for the development of this complication after gastrectomy with lymph node dissection.

Methods: We reviewed the medical records of 750 patients who underwent gastrectomy between January 2010 and May 2012, to establish the incidence of postoperative pneumonia (Clavien-Dindo grade II or higher). Univariate and multivariate analyses were performed to identify the risk factors for postoperative pneumonia.

Results: Thirty-two patients (4.3 %) suffered postoperative pneumonia, diagnosed as grades I, II, IIIa, and IVa, in 2 (0.3 %), 28 (3.7 %), 1 (0.2 %), and 1 (0.2 %) patient(s), respectively. Univariate analysis revealed that age (≥75 years), sex (male), diabetes mellitus (DM), a history of smoking, and impairment of respiratory function were significantly associated with postoperative pneumonia. Multivariate analysis revealed that age, impaired postoperative respiratory function, DM, and blood transfusion were independent risk factors for postoperative pneumonia.

Conclusions: Age, impaired postoperative respiratory function, DM, and blood transfusion were identified as independent risk factors for postoperative pneumonia after gastrectomy.

Keywords: Gastrectomy; Gastric cancer; Pneumonia.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Blood Transfusion
  • Diabetes Mellitus
  • Endoplasmic Reticulum, Smooth
  • Female
  • Gastrectomy*
  • Humans
  • Male
  • Middle Aged
  • Pneumonia / epidemiology
  • Pneumonia / etiology*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Respiration Disorders
  • Risk Factors
  • Stomach Neoplasms / surgery*
  • Young Adult