Predictors of Postoperative Pneumonia Following Anatomical Lung Resections in Thoracic Surgery

Background/Objectives: Postoperative pneumonia (PP) is a significant complication following thoracic surgery, increasing morbidity, mortality, and hospital length of stay. Identifying risk factors is crucial for optimizing perioperative management. This study analyses predictors for PP in patients undergoing anatomical lung resections in a single center setting. Methods: A prospective cohort study was conducted using data from the German Thoracic Registry (GTR). Patients who underwent anatomical lung resection were included in the study, while non-anatomical resections and cases with missing data were excluded. The primary outcome measure was the incidence of PP, which was analyzed using chi-square tests and Fisher's exact test. Results: PP was observed in 15.2% of the 381 patients. Significant preoperative predictors included American Society of Anesthesiologists (ASA) classification ≥ 3 (p = 0.021), C-reactive protein (CRP) ≥ 20 mg/L (p = 0.004), white blood cell count (WBC) ≥ 15,000/µL (p = 0.003) and forced expiratory volume in 1 s (FEV1) < 50% (p = 0.004). Intraoperative risk factors included thoracotomy (THT) (p = 0.001) and duration of operation > 180 min (p = 0.002). Postoperative predictors included Intensive Care Unit (ICU) admission (p < 0.001) and mechanical ventilation > 24 h (p < 0.001). PP was associated with a higher perioperative mortality rate (10.3% vs. 1.2%, p = 0.01) and prolonged hospital stay. Conclusions: A number of risk factors for the development of PP have been identified, which may help to reduce the incidence of the condition. For further validation, multicenter studies are required.