Risk factors for the development of postoperative pneumonia in patients after lung resection operations
Perkonos A.P., Stabrovska I.M.
Summary. Objective. To identify risk factors associated with the development of postoperative pneumonia (POP) in patients undergoing lung resection. Materials and methods. A retrospective analysis included 166 patients who underwent lung resections at the National Cancer Institute of Ukraine between June and December 2023. Pneumonectomy, diagnostic atypical resections, combined chest wall resections, and pediatric cases were excluded. POP was diagnosed based on radiological findings. Comorbidity burden was assessed using the Charlson Comorbidity Index (CCI). Statistical analysis comprised descriptive statistics, univariate analysis, and multivariate logistic regression. Results. POP occurred in 38 patients (22.9%) and was associated with a longer hospital stay. In univariate analysis, higher CCI, presence of metastases, and lower absolute FEV1 were associated with increased POP risk. Multivariate logistic regression identified CCI (Odds ratio (OR) = 1.18; 95% confidence interval (CI) 1.03–1.35; p=0.02) and metastatic disease (OR=2.45; 95% CI 1.12–5.36; p=0.02) as independent predictors of POP. Lower FEV1 showed a borderline association. Perioperative factors, including duration of anesthesia, one-lung ventilation, fluid therapy volume, opioid dose, and type of postoperative analgesia, were not independently associated with POP. Conclusions. Postoperative pneumonia remains a frequent complication after lung resection and is primarily associated with patient-related factors, particularly comorbidity burden and metastatic disease. Optimization of preoperative assessment and targeted monitoring of high-risk patients may help reduce postoperative morbidity.
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