Yang Rong, Du Chengli, Xu Jinming, Yao Linpeng, Zhang Siying, Wu Yihe
Department of Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China.
Department of Thoracic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China.
J Cardiothorac Surg. 2019 Nov 29;14(1):209. doi: 10.1186/s13019-019-1024-6.
Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy.
A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017-04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy.
The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m (vs. <24.0 kg/m: odds ratio 1.904, 95% confidence interval 1.294-2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216-2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302-3.260, P = 0.002).
Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.
电视辅助胸腔镜手术已在全球胸外科手术中广泛应用。我们的目标是确定接受电视辅助胸腔镜手术肺叶切除术患者术后肺炎的危险因素。
对2016年5月至2017年4月期间接受电视辅助胸腔镜手术肺叶切除术的成年患者进行回顾性分析。我们采用单因素分析和多因素分析来检查肺叶切除术后肺炎的危险因素。
术后肺炎的发生率为19.7%（n = 143/727）。与无术后肺炎的患者相比，术后肺炎患者的术后住院时间更长，总住院费用更高。多因素分析显示，体重指数分级≥24.0kg/m²（vs. <24.0kg/m²：比值比1.904，95%置信区间1.294 - 2.802，P = 0.001）和右肺叶手术（vs. 左肺叶手术：比值比1.836，95%置信区间1.216 - 2.771，P = 0.004）是术后肺炎的独立危险因素。术后24小时总静脉晶体液输注分级≥1500mL也被确定为危险因素（vs. 1000至<1500mL：比值比2.060，95%置信区间1.302 - 3.260，P = 0.002）。
电视辅助胸腔镜手术肺叶切除术后肺炎的主要危险因素是体重指数分级≥24.0kg/m²、右肺叶手术和术后24小时总静脉晶体液输注分级≥1500mL。
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