Department of Neurosurgery, West China Hospital, Sichuan University, Cheng Du, 610000, China.
BMC Cancer. 2019 Jan 23;19(1):100. doi: 10.1186/s12885-019-5271-7.
Post-operative pneumonia (Pop) following meningioma surgery is the dominant systemic complication which could cause serious threats to patients. It is unclear whether hematological biochemical markers are independently associated with the Pop. This study attempted to perform a more comprehensive study of taking both clinical factors and hematological biomarkers into account to promote the management of patients after meningioma surgery.
We collected clinical and hematological parameters of 1156 patients undergoing meningioma resection from January 2009 to January 2013. According to whether the symptoms of pneumonia had manifested,patients were divided into the Pop group and the Non-Pop group. We analyzed the distinctions of clinical factors between the two groups. We successively performed univariate and multivariate regression analysis to identify risk factors independently associated with the Pop.
4.4% patients infected with the Pop (51 of 1156). The median age at diagnosis of the Pop patients was significantly older than the Non-Pop group (p = 0.002). There were strike distinctions of post-operative hospital stays between two groups, with 21 days and 7 days each (p < 0.001). On multivariate analysis, tumor relapse (p < 0.001), skull base lesions (p = 0.001), intra-operative blood transfusion (p = 0.018) and cardiovascular diseases (p = 0.001) were linked with increased risk of the Pop following meningioma resection. For hematological biochemical markers, it was the factor of Red blood cell distribution width-standard deviation (RDW-SD) (OR 5.267, 95%CI 1.316, 21.078; p = 0.019) and Neutrophils lymphocytes ratio (NLR) (OR 2.081, 95%CI 1.063, 4.067; p = 0.033) that could appreciably predict the Pop.
Apart from tumor recurrence, localizations, intra-operative blood transfusion and cardiovascular diseases are independent risk factors for the Pop. We initially found hematological RDW-SD and NLR are also important predictors.
脑膜瘤手术后的肺炎（Pop）是一种主要的全身并发症，可对患者造成严重威胁。目前尚不清楚血液生化标志物是否与 Pop 有独立关联。本研究试图更全面地研究同时考虑临床因素和血液生物标志物，以促进脑膜瘤手术后患者的管理。
我们收集了 2009 年 1 月至 2013 年 1 月期间 1156 例接受脑膜瘤切除术的患者的临床和血液学参数。根据是否出现肺炎症状，将患者分为 Pop 组和非 Pop 组。我们分析了两组之间临床因素的差异。我们分别进行单因素和多因素回归分析，以确定与 Pop 独立相关的危险因素。
4.4%的患者（1156 例中有 51 例）发生 Pop。Pop 患者的中位年龄明显大于非 Pop 组（p=0.002）。两组患者的术后住院时间存在明显差异，分别为 21 天和 7 天（p<0.001）。多因素分析显示，肿瘤复发（p<0.001）、颅底病变（p=0.001）、术中输血（p=0.018）和心血管疾病（p=0.001）与脑膜瘤切除术后 Pop 的发生风险增加相关。对于血液生化标志物，红细胞分布宽度标准差（RDW-SD）（OR 5.267，95%CI 1.316，21.078；p=0.019）和中性粒细胞与淋巴细胞比值（NLR）（OR 2.081，95%CI 1.063，4.067；p=0.033）是 Pop 的显著预测因素。
除肿瘤复发外，局部、术中输血和心血管疾病也是 Pop 的独立危险因素。我们首次发现血液学 RDW-SD 和 NLR 也是重要的预测因素。
