Mohri Yasuhiko, Tonouchi Hitoshi, Miki Chikao, Kobayashi Minako, Kusunoki Masato
Department of Gastrointestinal Surgery and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie 514-8507, Japan.
World J Surg. 2008 Jun;32(6):1045-50. doi: 10.1007/s00268-008-9534-8.
Postoperative hospital-acquired pneumonia (HAP) is recognized as a major risk associated with surgery. Although upper abdominal surgery is known to have the highest incidence of postoperative HAP, little is known about the risk factors that contribute to HAP after gastric cancer surgery. The aim of this study was to determine the incidence and risk factors for HAP after elective surgery for gastric cancer.
We conducted prospective surveillance of all elective gastric resections by surgeons in ten affiliated hospitals, including ours, from May 2001 to May 2005. The outcome of interest was postoperative HAP. Univariate and multivariate analyses were performed to determine the predictive significance of variables in gastric cancer surgery.
A total of 529 patients undergoing elective operations for gastric cancer were admitted to the program. Postoperative HAP was identified in 20 patients (3.6%). Univariate and multivariate analyses showed that male gender and intra- and/or postoperative blood transfusion were independently predictive of postoperative HAP.
Male gender and intra- and/or postoperative blood transfusion were independent risk factors for the development of HAP after elective resection of gastric cancer. Surgeons should keep these risk factors in mind when managing postoperative patients.
术后医院获得性肺炎（HAP）被认为是与手术相关的主要风险。尽管上腹部手术的术后HAP发病率最高，但对于胃癌手术后导致HAP的危险因素知之甚少。本研究的目的是确定择期胃癌手术后HAP的发病率和危险因素。
我们对包括我院在内的十家附属医院的外科医生在2001年5月至2005年5月期间进行的所有择期胃癌切除术进行了前瞻性监测。感兴趣的结局是术后HAP。进行单因素和多因素分析以确定变量在胃癌手术中的预测意义。
共有529例接受择期胃癌手术的患者纳入本研究。20例患者（3.6%）被诊断为术后HAP。单因素和多因素分析表明，男性以及术中及/或术后输血是术后HAP的独立预测因素。
男性以及术中及/或术后输血是择期胃癌切除术后发生HAP的独立危险因素。外科医生在管理术后患者时应牢记这些危险因素。
