Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia.

Studer, Peter; Räber, Geneviève; Ott, Daniel; Candinas, Daniel; Schnüriger, Beat (2016). Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia. International journal of surgery, 27, pp. 21-25. Elsevier 10.1016/j.ijsu.2016.01.043

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INTRODUCTION Aspiration pneumonia in hospitalized surgical patients has been associated with a mortality of approximately 30%. The aim of this study was to assess pre-, intra- and postoperative risk factors for mortality in patients suffering aspiration pneumonia after abdominal surgery. METHODS Retrospective study from 01/2006-12/2012 of patients with clinically and radiologically confirmed aspiration pneumonia after abdominal surgery. RESULTS A total of 70 patients undergoing abdominal surgery and postoperative aspiration pneumonia were identified. There were 53 (76%) male patients, the mean age was 71 ± 12 years and the mean ASA score was 3 ± 1. The surgical procedures included 32 colorectal or small bowel resections, 10 partial liver resections, 9 gastric surgeries, 8 esophageal resections, 5 pancreatic surgeries, and 6 hernia repairs. Aspiration pneumonia occurred at mean postoperative day 7 ± 10. Overall, 53% (n = 37) of patients required re-intubation, with 4 ± 5 days of additional mechanical ventilation. Mean hospital and ICU length of stay was 32 ± 25 days and 6 ± 9 days, respectively. Overall mortality was 27% (n = 19). Forward logistic regression revealed older age [OR 7.41 (95% CI: 1.29-42.62)], bilateral aspiration pneumonia [OR 7.39 (95% CI: 1.86-29.29)] and intraoperative requirement of blood component transfusion [OR 5.09 (95% CI: 1.34-19.38)] as independent risk factors for mortality (overall R(2) = 0.336). CONCLUSION Postoperative aspiration pneumonia remains a severe complication with significant mortality. Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia. Therefore, these patients suffering aspiration pneumonia require special attention and increased monitoring.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Medicine

UniBE Contributor:

Studer, Peter; Räber, Geneviève; Ott, Daniel; Candinas, Daniel and Schnüriger, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1743-9191

Publisher:

Elsevier

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

29 Mar 2017 16:18

Last Modified:

09 Sep 2017 21:36

Publisher DOI:

10.1016/j.ijsu.2016.01.043

PubMed ID:

26804349

Uncontrolled Keywords:

Abdominal surgery; Aspiration pneumonia; Complication; Critical care

BORIS DOI:

10.7892/boris.93393

URI:

https://boris.unibe.ch/id/eprint/93393

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