Predictive Risk Factors for Postoperative Pneumonia After Heart Transplantation

Overview

Journal BMC Anesthesiol

Publisher Biomed Central

Specialty Anesthesiology

Date 2020 Jan 9

PMID 31910812

Citations 2

Authors

Charles Vidal

Romain Pasqualotto

Arthur James

Pauline Dureau

Julie Rasata

Guillaume Coutance

Shaida Varnous

Pascal Leprince

Julien Amour

Adrien Bougle

Affiliations

Soon will be listed here.

Abstract

Background: Pneumonia is a frequent complication in patients undergoing heart transplantation (HTx) that increases morbidity and mortality in this population. Nevertheless, the risk factors for postoperative pneumonia (POP) are still unknown. The aim of this study was to investigate the predictive risk factors for POP in HTx recipients.

Methods: In this retrospective study, all patients undergoing HTx between January 2014 and December 2015 were included. All cases of POP occurring until hospital discharge were investigated. The study aimed to determine risk factors using univariate and multivariate Cox regression models. Data are expressed in Odds Ratio [95% CI]. P < 0.05 was necessary to reject the null hypothesis.

Results: A total of 175 patients were included without any patients being lost to follow-up, and 89 instances of POP were diagnosed in 59 (34%) patients. Enterobacteriaceae and Pseudomonas aeruginosa were the most common pathogens. In the multivariate analysis, the risk factors were preoperative mechanical ventilation (OR 1.42 [1.12-1.80], P < 0.01) and perioperative blood transfusion (OR 1.42 [95% CI: 1.20-1.70], P < 0.01). POP significantly impacted mortality at 30 days (OR: 4 [1.3-12.4], P = 0.01) and 1 year (OR: 6.8 [2.5-8.4], P < 0.01) and was associated with a longer duration of mechanical ventilation, time to weaning from venoarterial extracorporeal membrane oxygenation and stay in an intensive care unit. Plasma exchanges and intravenous administration of immunoglobulins did not increase the risk of POP.

Conclusion: After HTx, preoperative mechanical ventilation and blood transfusion were risk factors for POP and were associated with increased mortality. Enterobacteriaceae and Pseudomonas aeruginosa are the most common pathogens of POP.

Citing Articles

Association between Hospital-Acquired Pneumonia and In-Hospital Mortality in Solid Organ Transplant Admissions: An Observational Analysis in Spain, 2004-2021.

de-Miguel-Yanes J, Lopez-de-Andres A, Jimenez-Garcia R, Zamorano-Leon J, Carabantes-Alarcon D, Omana-Palanco R J Clin Med. 2023; 12(17).

PMID: 37685599 PMC: 10488258. DOI: 10.3390/jcm12175532.

Pneumonia After Cardiovascular Surgery: Incidence, Risk Factors and Interventions.

Wang D, Lu Y, Sun M, Huang X, Du X, Jiao Z Front Cardiovasc Med. 2022; 9:911878.

PMID: 35845037 PMC: 9280273. DOI: 10.3389/fcvm.2022.911878.

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