Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients

Yasuhiro Tsubosa, Hiroshi Sato, Yuji Tachimori, Nobukazu Hokamura, Masao Hosokawa, Yoshihiro Kinoshita, Hiroyuki Daiko, Harushi Udagawa, Masaki Ueno, Yasuyuki Seto, Keiichi Jinbo, Yuukou Kitagawa, Hiroya Takeuchi, Mijong Park, Shiori Nagasaka, Hiroshi Yamada, Yojiro Ota

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies. Purpose: To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia. Methods: Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38°C or higher, and purulent sputum. Results: Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 %). The risk of postoperative pneumonia was associated with a preoperative body weight loss of 5 % or more and late tracheal tube extubation. Conclusions: This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.

Original languageEnglish
Pages (from-to)126-135
Number of pages10
JournalEsophagus
Volume11
Issue number2
DOIs
Publication statusPublished - 2014

Fingerprint

Esophageal Neoplasms
Pneumonia
Thorax
Retrospective Studies
Esophagectomy
Airway Extubation
Weight Loss
Logistic Models
Body Weight
Body Temperature
Sputum
Morbidity
Lung

Keywords

  • Body weight loss
  • Diagnostic criteria for postoperative pneumonia
  • Early extubation
  • Esophageal carcinoma
  • Postoperative pneumonia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Tsubosa, Y., Sato, H., Tachimori, Y., Hokamura, N., Hosokawa, M., Kinoshita, Y., ... Ota, Y. (2014). Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients. Esophagus, 11(2), 126-135. https://doi.org/10.1007/s10388-014-0423-y

Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients. / Tsubosa, Yasuhiro; Sato, Hiroshi; Tachimori, Yuji; Hokamura, Nobukazu; Hosokawa, Masao; Kinoshita, Yoshihiro; Daiko, Hiroyuki; Udagawa, Harushi; Ueno, Masaki; Seto, Yasuyuki; Jinbo, Keiichi; Kitagawa, Yuukou; Takeuchi, Hiroya; Park, Mijong; Nagasaka, Shiori; Yamada, Hiroshi; Ota, Yojiro.

In: Esophagus, Vol. 11, No. 2, 2014, p. 126-135.

Research output: Contribution to journalArticle

Tsubosa, Y, Sato, H, Tachimori, Y, Hokamura, N, Hosokawa, M, Kinoshita, Y, Daiko, H, Udagawa, H, Ueno, M, Seto, Y, Jinbo, K, Kitagawa, Y, Takeuchi, H, Park, M, Nagasaka, S, Yamada, H & Ota, Y 2014, 'Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients', Esophagus, vol. 11, no. 2, pp. 126-135. https://doi.org/10.1007/s10388-014-0423-y
Tsubosa, Yasuhiro ; Sato, Hiroshi ; Tachimori, Yuji ; Hokamura, Nobukazu ; Hosokawa, Masao ; Kinoshita, Yoshihiro ; Daiko, Hiroyuki ; Udagawa, Harushi ; Ueno, Masaki ; Seto, Yasuyuki ; Jinbo, Keiichi ; Kitagawa, Yuukou ; Takeuchi, Hiroya ; Park, Mijong ; Nagasaka, Shiori ; Yamada, Hiroshi ; Ota, Yojiro. / Multi-institution retrospective study of the onset frequency of postoperative pneumonia in thoracic esophageal cancer patients. In: Esophagus. 2014 ; Vol. 11, No. 2. pp. 126-135.
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abstract = "Background: Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies. Purpose: To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia. Methods: Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38°C or higher, and purulent sputum. Results: Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 {\%}). The risk of postoperative pneumonia was associated with a preoperative body weight loss of 5 {\%} or more and late tracheal tube extubation. Conclusions: This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.",
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AU - Tsubosa, Yasuhiro

AU - Sato, Hiroshi

AU - Tachimori, Yuji

AU - Hokamura, Nobukazu

AU - Hosokawa, Masao

AU - Kinoshita, Yoshihiro

AU - Daiko, Hiroyuki

AU - Udagawa, Harushi

AU - Ueno, Masaki

AU - Seto, Yasuyuki

AU - Jinbo, Keiichi

AU - Kitagawa, Yuukou

AU - Takeuchi, Hiroya

AU - Park, Mijong

AU - Nagasaka, Shiori

AU - Yamada, Hiroshi

AU - Ota, Yojiro

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N2 - Background: Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies. Purpose: To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia. Methods: Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38°C or higher, and purulent sputum. Results: Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 %). The risk of postoperative pneumonia was associated with a preoperative body weight loss of 5 % or more and late tracheal tube extubation. Conclusions: This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.

AB - Background: Esophagectomy for thoracic esophageal cancer is a highly invasive procedure. Most studies analyzing the risk factors for pulmonary morbidity were conducted in the early 1990s. However, previous studies did not use fixed diagnostic criteria for postoperative pneumonia and reported widely varying onset frequencies. Purpose: To define postoperative pneumonia diagnostic criteria, clarify the onset frequency of postoperative pneumonia after esophagectomy in accordance with these criteria, and investigate the risk factors of postoperative pneumonia. Methods: Risk factors for postoperative pneumonia were analyzed in 615 patients who underwent esophagectomy between January 2006 and December 2007 at 7 Japanese institutions using logistic regression models. The necessary criterion for a pneumonia diagnosis was an infiltrative shadow on a chest radiograph. Furthermore, a pneumonia diagnosis was based on the presence of at least 2 of the following 3 criteria: white blood count abnormalities, body temperature of 38°C or higher, and purulent sputum. Results: Overall, 615 patients were statistically analyzed. Pneumonia onset occurred in 66 cases (10.7 %). The risk of postoperative pneumonia was associated with a preoperative body weight loss of 5 % or more and late tracheal tube extubation. Conclusions: This study revealed that preoperative body weight loss increased the risk of postoperative pneumonia after esophagectomy for esophageal cancer, while early-stage tracheal tube extubation reduced the risk.

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