Anesthetic predictors for postoperative pneumonia in patients with non-small cell lung cancer.

ABSTRACT

Background: Postoperative pneumonia (POP) is a preventable complication associated with adverse outcomes. The aim of this study is to explore the anesthetic predictor for POP in patients with non-small cell lung cancer (NSCLC) after surgery. Methods: A total of 306 patients with NSCLC were selected. Multivariable logistic regression analysis model was used to screen the independent predictors for POP. The primary outcome was POP and the secondary outcomes were intensive care unit (ICU) admission rate, reintubation rate and postoperative hospital stay (PHS). Results: POP occurred in 102 (33.3%) of 306 patients. Multivariable logistic regression analysis showed that perioperative propofol administration >4.42 mg/kg [odds ratio (OR) =0.543, 95% confidence interval (CI) 0.330-0.895, P=0.02] lowered the risk of POP, while duration of surgery >3 h (OR =1.951, 95% CI 1.189-3.199, P=0.008) and total intraoperative fluid infusion >1,450 mL (OR =2.428, 95% CI 1.307-4.509, P=0.005) were associated with the increasing risk of POP. There was a higher ICU admission and reintubation rate in the POP group (P<0.05). Conclusions: Perioperative propofol administration >4.42 mg/kg may diminish the incidence of POP, while duration of surgery >3 h and intraoperative fluid infusion >1,450 mL increase the development of POP.