Incidence, Patient-Related Risk Factors, and Outcomes of Postoperative Pneumonia after Cholecystectomy: A Population-Based Cohort Study

• Published in: BioMed research international 2021, Vol.2021, p.6614885-8
• Main Authors: Teng, Yun-Hui, Liu, Fu-Chao, Liu, Keng-Hao, Lin, Jr-Rung, Yu, Huang-Ping
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cerebrovascular diseases; Chi-square test; Cholecystectomy; Cholecystectomy - adverse effects; Chronic obstructive pulmonary disease; Cirrhosis; Cohort analysis; Cohort Studies; Comorbidity; Complications; Congestive heart failure; Coronary artery; Coronary artery disease; Databases, Factual; Demographics; Diabetes mellitus; Disease Progression; Female; Health insurance; Hemodialysis; Hospitalization; Humans; Incidence; Liver cirrhosis; Liver diseases; Lung diseases; Male; Middle Aged; Morbidity; Mortality; Obstructive lung disease; Patients; Pneumonia; Pneumonia - complications; Pneumonia - epidemiology; Population studies; Population-based studies; Postoperative Complications - epidemiology; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - epidemiology; Rank tests; Regression analysis; Renal Dialysis; Risk analysis; Risk Factors; Risk management; Sex; Statistical tests; Surgery; Taiwan - epidemiology
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2021/6614885

Background. Cholecystectomy is one of the most common surgical procedures performed worldwide. The objective of this large, population-based cohort study is to explore the risk factors of pneumonia after cholecystectomy in Taiwan. Methods. From the Taiwanese National Health Insurance Research Database, we selected all patients who underwent cholecystectomy by using ICD-9-codes, from January 1, 1998, to December 31, 2016. The patients were separated into two groups based on the presence or absence of postoperative pneumonia. Basic information, comorbidities, and postoperative complications were evaluated using a t-test or chi-square test. There were 6056 patients in the pneumonia group and 24224 patients in the control group. These two groups were shown in a ratio of 1 : 4 and were matched by age and sex. The log-rank test was used to examine differences in postoperative mortality between patients with and without pneumonia. Preoperative risk factors were analyzed using logistic regression analysis, after adjusting for age and sex. Results. The final dataset included 282184 cholecystectomy patients. Of these patients, 6056 (2.15%) had postoperative new-onset pneumonia. The patient-related risk factors for pneumonia after cholecystectomy in the order of relevance were chronic obstructive pulmonary disease, congestive heart failure, cerebrovascular disease, diabetes mellitus, surgical type, hemodialysis, coronary artery disease, and liver cirrhosis. Compared to patients without postcholecystectomy pneumonia, those with postcholecystectomy pneumonia had higher rates of mortality (within first month, 1.72% vs. 2.28%, P