Risk Factors For Postoperative Pneumonia After Colon Cancer Radical Resection

Background According to statistics, there are about 8 million people undergo colon cancer every year, accounted for 10%～15% of new malignant tumor. Studies show that increasing incidence of colon cancer in the world scope, especially in older people. In our country, colon cancer is still the common malignant tumor in gastrointestinal tract tumors, and the incidence of colon cancer increasing in the past years. the onset age between 41～65 years old is higher than others, especially in our city regions. According the trend of the investigation, the incidence of colon cancer will increase for a long time. The incidence of colon cancer complicated postoperative pneumonia after surgery also increase, no study has sufficiently investigated which clinicopathological factors are significant risk factors for the development of this complication after colon cancer radical resection with lymph node dissection.Objectives To investigate the factors of postoperative pneumonia after colon cancer radical resection with lymph node dissection and provide a reference for the clinical prevention of postoperative pneumonia.Methods Totally 325 patients who underwent colon cancer radical resection with lymph node dissection in Shandong provincial Hospital between October 2013 and October 2015. The following preoperative factors were collected:gender,age, body mass index (BMI),preoperative serum albumin, preoperative hemoglobin, presence/absence of diabetes mellitus (DM), history of smoking (ever or never), respiratory function test results, tumor size,lymph node metastases, and tumor size. operation time, history of perioperative blood transfusion, and estimated blood loss. the type of surgical procedure, Pulmonary infection diagnostic criteria: refer to "nosocomial acquired bronchitis, lung infection diagnostic criteria" and Dilworth "integral criteria for diagnosis of abdominal surgery postoperative pulmonary infection" and to establish the incidence of postoperative pneumonia (Clavien-Dindo grade Ⅱ or higher). Univariate and multivariate analyses were performed to identify the risk factors for postoperative pneumonia.Results sixteen patients (4.0%) suffered postoperative pneumonia, diagnosed as grades Ⅱ, Ⅲa, and Ⅳa,13(3.5%),1(0.3%), and 1(0.3%) patient(s), respectively. Univariate analysis revealed that age (≥75 years), sex (male), diabetes mellitus (DM), a history of smoking, and impairment of respiratory function were significantly associated with postoperative pneumonia. Multivariate analysis revealed that age, impaired postoperative respiratory function, DM, and blood transfusion were independent risk factors for postoperative pneumonia.Conclusions Age, impaired postoperative respiratory function, DM, and blood transfusion were identified as independent risk factors for postoperative pneumonia after colon cancer radical resection.