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Frailty as a predictor of postoperative aspiration pneumonia after abdominal surgery for digestive cancers
Shinichiro Yamada1, Yuji Morine, Tetsuya Ikemoto
1Department of Surgery, Tokushima University, Tokushima City, Tokushima, Japan.
Abstract:
This study was performed to investigate the factors associated with the development of postoperative aspiration pneumonia (PAP) after abdominal surgery for digestive cancers. The study involved 420 patients who had undergone abdominal surgery for digestive cancers. The patients were divided into a PAP group (n = 13) and non-PAP group (n = 407), and clinicopathological factors were compared between the 2 groups. Logistic regression analysis was used to assess the predictors of PAP, and develop a formula for the prediction of PAP. The PAP group showed a higher white blood cell count, C-reactive protein concentration, and modified Glasgow prognostic score and a lower albumin concentration than the non-PAP group (P < .05). The PAP group also showed a significantly higher rate of frailty and longer postoperative hospital stay (P < .05). The multivariate analysis revealed that cerebrovascular disease, respiratory complications, and frailty were independent predictive factors of PAP (P < .05). A prediction formula established using these factors showed a sensitivity of 92.3% and specificity of 76.4%. Evaluation of the preoperative frailty status is important for risk stratification and prevention of postoperative morbidity in patients undergoing surgery.
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