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Predictive risk factors for postoperative pneumonia after heart transplantation
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 r...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947950/ https://www.ncbi.nlm.nih.gov/pubmed/31910812 http://dx.doi.org/10.1186/s12871-019-0923-3 |
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author | Vidal, Charles Pasqualotto, Romain James, Arthur Dureau, Pauline Rasata, Julie Coutance, Guillaume Varnous, Shaida Leprince, Pascal Amour, Julien Bouglé, Adrien |
author_facet | Vidal, Charles Pasqualotto, Romain James, Arthur Dureau, Pauline Rasata, Julie Coutance, Guillaume Varnous, Shaida Leprince, Pascal Amour, Julien Bouglé, Adrien |
author_sort | Vidal, Charles |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6947950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69479502020-01-09 Predictive risk factors for postoperative pneumonia after heart transplantation Vidal, Charles Pasqualotto, Romain James, Arthur Dureau, Pauline Rasata, Julie Coutance, Guillaume Varnous, Shaida Leprince, Pascal Amour, Julien Bouglé, Adrien BMC Anesthesiol Research Article 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. BioMed Central 2020-01-07 /pmc/articles/PMC6947950/ /pubmed/31910812 http://dx.doi.org/10.1186/s12871-019-0923-3 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Vidal, Charles Pasqualotto, Romain James, Arthur Dureau, Pauline Rasata, Julie Coutance, Guillaume Varnous, Shaida Leprince, Pascal Amour, Julien Bouglé, Adrien Predictive risk factors for postoperative pneumonia after heart transplantation |
title | Predictive risk factors for postoperative pneumonia after heart transplantation |
title_full | Predictive risk factors for postoperative pneumonia after heart transplantation |
title_fullStr | Predictive risk factors for postoperative pneumonia after heart transplantation |
title_full_unstemmed | Predictive risk factors for postoperative pneumonia after heart transplantation |
title_short | Predictive risk factors for postoperative pneumonia after heart transplantation |
title_sort | predictive risk factors for postoperative pneumonia after heart transplantation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947950/ https://www.ncbi.nlm.nih.gov/pubmed/31910812 http://dx.doi.org/10.1186/s12871-019-0923-3 |
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