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Pneumonia after Major Cancer Surgery: Temporal Trends and Patterns of Care

Vincent Q Trinh1, Praful Ravi2, Abd-El-Rahman M Abd-El-Barr3

  • 1Departement of Pathology and Cellular Biology, University of Montreal Health Center, Montreal, QC, Canada H2X 0A9.

Canadian Respiratory Journal
|July 23, 2016
PubMed

Insights

Postoperative pneumonia after major cancer surgery (MCS) increased in prevalence from 1999-2009. While overall mortality decreased, pneumonia significantly raises mortality risk, highlighting the need for early identification of at-risk patients.

Area of Science:

  • Oncology
  • Pulmonology
  • Health Services Research

Background:

  • Pneumonia is a significant postoperative complication following major cancer surgery (MCS).
  • Understanding trends and risk factors for postoperative pneumonia is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the trends, associated factors, and mortality related to postoperative pneumonia after major cancer surgery.
  • To identify patient and hospital characteristics that increase the risk of developing pneumonia post-MCS.

Main Methods:

  • Utilized the Nationwide Inpatient Sample (NIS) database from 1999 to 2009, including over 2.5 million patients undergoing major cancer surgery.
  • Employed logistic regression analysis with generalized estimating equations to identify determinants of pneumonia and associated mortality.

Main Results:

  • Pneumonia prevalence after MCS increased by 29.7% between 1999 and 2009.
  • Factors associated with higher pneumonia risk included older age, male sex, comorbidities, non-private insurance, lower income, higher hospital volume, urban location, Northeast region, and non-teaching hospitals.
  • Pneumonia conferred a 6.3-fold increased odds of mortality, despite an overall decrease in MCS mortality.

Conclusions:

  • The rising prevalence of pneumonia post-MCS, with stable mortality rates, may indicate improved diagnosis or coding practices.
  • Identifying at-risk patient populations is essential for targeted interventions to reduce the incidence and impact of postoperative pneumonia.
  • Postoperative pneumonia remains a critical factor significantly increasing mortality risk after major cancer surgery.

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