Incidence and Risk Factors for Postoperative Pneumonia (POP) after Major Oral and Maxillofacial Surgery
Article Sidebar
Main Article Content
Abstract
Postoperative pneumonia (POP) is a condition of lung inflammation that occurs after surgery, often resulting from a hospital-acquired or ventilator-associated lung infection within 48-72 hours of surgery. Previous studies have reported an 18.8% incidence of postoperative pneumonia after oral and maxillofacial surgery. However, there is no study in Thailand regarding the incidence of postoperative pneumonia after oral and maxillofacial surgery and the related risk factors. This research aimed to investigate the incidence and factors related to postoperative pneumonia after oral and maxillofacial surgery. This study is a prospective analytical study conducted by collecting data from a sample of 93 patients who underwent major oral and maxillofacial surgery at the Dental Hospital, Faculty of Dentistry, Khon Kaen University. The results showed that 10.8% of the sample had postoperative pneumonia. Risk factors associated with postoperative pneumonia included age over 55 years, surgery duration longer than 360 minutes, tracheostomy, and an ASA classification of 3 or higher. This study revealed that patients aged 55 years and older had a 27.75 times higher risk of developing postoperative pneumonia compared to younger patients, and those with surgery durations longer than 360 minutes had a 7.91 times higher risk. In conclusion, the incidence of postoperative pneumonia after oral and maxillofacial surgery is 10.8%. Patients aged 55 years and older have a 27.75 times higher risk of developing postoperative pneumonia compared to patients younger than 55 years. Additionally, patients with surgery durations exceeding 360 minutes have a 7.91 times higher risk of developing postoperative pneumonia compared to those with a shorter surgery duration.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการลงตีพิมพ์ในวิทยาสารทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นถือเป็นลิขสิทธิ์เฉพาะของคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่น หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด ๆ จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษร จากคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นก่อนเท่านั้น
References
Sattar SBA, Sharma S. Bacterial Pneumonia. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513321/
Reechaipichitkul V. HAP, VAP and HCAP Guidelines: from Guidelines to Clinical Practice. Srinagarind Med J 2010;25(Suppl):87-94.
Chughtai M, Gwam CU, Mohamed N, Khlopas A, Newman JM, Khan R, et al. The epidemiology and risk factors for postoperative pneumonia. J Clin Med Res 2017;9(6):466-75.
Wysock J. Preoperative pulmonary assessment and Management of Pulmonary Complications. In: Samir S. Taneja, Ojas Shah. Complication of Urologic Surgery. 5th ed. Sydney: Elsevier; 2018.12-20.
Klompas M. Clinical evaluation and diagnostic testing for community-acquired pneumonia in adults. [Updated 2023 Jan 03]. In: Uptodate.com [Internet]. Available from:https://www.uptodate.com/contents/clinical-evaluation-and-diagnostic-testing-for-community-acquired-pneumonia-in-adults#disclaimerContent
National Healthcare Safety Network. Pneumonia (Ventilator-associated [VAP] and non-ventilator- associated Pneumonia [PNEU]) Event. Centers Dis Control Prev. January 2022. [cited 2022 Sep 24]. Available from:https://www.cdc.gov/nhsn/pdfs/checklists/pneu-checklist-508.pdf
Loeffelbein DJ, Julinek A, Wolff KD, Kochs E, Haller B, Haseneder R. Perioperative risk factors for postoperative pulmonary complications after major oral and maxillofacial surgery with microvascular reconstruction: A retrospective analysis of 648 cases. J Cranio-Maxillofacial Surg 2016;44(8):952-57.
Combes J, Gibbons A. Oral and Maxillofacial Surgery. J R Army Med Corps 2007;153(3):205-09.
Strobel RJ, Liang Q, Zhang M, Wu X, Rogers MA, Theurer PF, et al. A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting. Ann Thorac Surg 2016;102(4):1213-19.
Likosky DS, Paone G, Zhang M, Rogers MA, Harrington SD, Theurer PF, et al. Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting. Ann Thorac Surg 2015; 100(3):794-801.
Poelaert J, Haentjens P, Blot S. Association among duration of mechanical ventilation, cuff material of endotracheal tube, and postoperative nosocomial pneumonia in cardiac surgical patients: A prospective study. J Thorac Cardiovasc Surg 2014;148(4):1622-27.
Lugg ST, Agostini PJ, Tikka T, Kerr A, Adams K, Bishay E, et al. Long-term impact of developing a postoperative pulmonary complication after lung surgery. Thorax 2016;71(2):171-76.
Wang Z, Cai XJ, Shi L, Li FY, Lin NM. Risk factors of postoperative nosocomial pneumonia in stage I-IIIa lung cancer patients. Asian Pacific J Cancer Prev 2014;15(7):3071-74.
Kobayashi S, Karube Y, Nishihira M, Inoue T, Araki O, Maeda S, et al. Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection. Gen Thorac Cardiovasc Surg 2016;64(8):476-80.
Karam J, Shepard A, Rubinfeld I. Predictors of operative mortality following major lower extremity amputations using the National Surgical Quality Improvement Program public use data. J Vasc Surg 2013;58(5):1276-82.
Damian D, Esquenazi J, Duvvuri U, Johnson JT, Sakai T. Incidence, outcome, and risk factors for postoperative pulmonary complications in head and neck cancer surgery patients with free flap reconstructions. J Clin Anesth 2016;28:12-18.
Ruohoalho J, Xin G, Bäck L, Aro K, Tapiovaara L. Tracheostomy complications in otorhinolaryngology are rare despite the critical airway. Eur Arch Oto-Rhino-Laryngology 2021;278(11):4519-23.
Xiang B, Jiao S, Si Y, Yao Y, Yuan F, Chen R. Risk factors for postoperative pneumonia: A case-control study. Front Public Heal 2022;10:913897.
Li L, Yuan W, Zhang S, Wang K, Ruan H. Analysis of risk factors for pneumonia in 482 patients undergoing oral cancer surgery with tracheotomy. J Oral Maxillofac Surg 2016;74(2):415-19.
Vasudevan K, Grossberg JA, Spader HS, Torabi R, Oyelese AA. Age increases the risk of immediate postoperative dysphagia and pneumonia after odontoid screw fixation. Clin Neurol Neurosurg 2014;126:185-89.
Hackett NJ, De Oliveira GS, Jain UK, Kim JYS. ASA class is a reliable independent predictor of medical complications and mortality following surgery. Int J Surg 2015;18:184-90.
Wolfer S, Foos T, Kunzler A, Ernst C, Schultze-Mosgau S. Association of the preoperative body mass index with postoperative complications after treatment of oral squamous cell carcinoma. J Oral Maxillofac Surg 2018;76(8):1800-15.
Buitelaar DR, Balm AJM, Antonini N, van Tinteren H, Huitink JM. Cardiovascular and respiratory complications after major head and neck surgery. Head Neck 2006;28(7):595-02.
Zhao T, Wu X, Zhang Q, Li C, Worthington H V, Hua F. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane Database Syst Rev 2020;12(12):CD008367.
Dillon JK, Liu SY, Patel CM, Schmidt BL. Identifying risk factors for postoperative cardiovascular and respiratory complications after major oral cancer surgery. Head Neck 2011;33(1):112-16.
Moratin J, Zittel S, Horn D, Behnisch R, Ristow O, Engel M, et al. Free-flap reconstruction in early-stage squamous cell carcinoma of the oral cavity-a prospective monocentric trial to evaluate oncological outcome and quality of life. J Clin Med 2023;12(14):4833.
Cronin ED, Williams JL, Shayani P, Roesel JF. Short stay after cleft palate surgery. Plast Reconstr Surg 2001;108(4):838-40.
Grosser R, Romero-Velez G, Pereira X, Moran-Atkin E, Choi J, Camacho DR. Postoperative pneumonia after bariatric surgery during the COVID-19 pandemic: a National Surgical Quality Improvement Program study. Surg Obes Relat Dis 2022;18(10):1239-45.
Cornellà N, Sancho J, Sitges-Serra A. Short and long-term outcomes after surgical procedures lasting for more than six hours. Sci Rep 2017;7(1):9221.
Rao MK, Reilley TE, Schuller DE, Young DC. Analysis of risk factors for postoperative pulmonary complications in head and neck surgery. Laryngoscope 1992;102(1):45-7.
American Society of Anesthesiologists. Statement on ASA physical status classification system. [Updated 2020 Dec 13] Available from: https://www.asahq.org/standards-and-practice-parameters/statement-on-asa-physical-status-classification-system
Denholm KA, Steel BJ, Wilson A, Nugent M, Burns A. Factors determining postoperative length of stay and time to resumption of feeding following free flap reconstruction for oral cancer. Br J Oral Maxillofac Surg 2022;60(9):1240-45.
Penel N, Mallet Y, Roussel-Delvallez M, Lefebvre JL, Yazdanpanah Y. Factors determining length of the postoperative hospital stay after major head and neck cancer surgery. Oral Oncol 2008;44(6):555-62.
Lupei MI, Chipman JG, Beilman GJ, Oancea SC, Konia MR. The association between ASA status and other risk stratification models on postoperative intensive care unit outcomes. Anesth Analg 2014;118(5):989-94