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Multi-institution retrospective study of the onset frequency -of postoperative pneumonia in thoracic esophageal cancer patients

机译：胸段食管癌患者术后肺炎发作频率的多机构回顾性研究

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Background Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies. Purpose To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia. Methods Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38 °C or higher, and purulent sputum. Results Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 %). The risk of postoperative pneumonia was associated with a preopera-tive body weight loss of 5 % or more and late tracheal tube extubation. Conclusions This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.
机译：背景技术针对胸段食管癌的食管切除术是一种高度侵入性的手术。大多数分析肺部疾病危险因素的研究都是在1990年代初期进行的。但是，先前的研究并未对术后肺炎使用固定的诊断标准，并且报道了发病频率差异很大。目的定义术后肺炎的诊断标准，根据这些标准明确食管切除术后术后肺炎的发作频率，并调查术后肺炎的危险因素。方法采用logistic回归模型分析了2006年1月至2007年12月在日本7家机构进行食管切除术的615例患者的术后肺炎危险因素。诊断为肺炎的必要标准是胸部X光片上有浸润性阴影。此外，肺炎的诊断是基于以下三个标准中的至少两个：白细胞计数异常，体温在38°C或更高以及脓性痰。结果总共对615例患者进行了统计分析。发生肺炎66例（10.7％）。术后发生肺炎的风险与术前体重减轻5％或更多以及气管插管晚期拔管有关。结论：这项研究表明，术前体重减轻会增加食管癌食管癌切除术后发生肺炎的风险，而早期气管插管会降低这一风险。

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