Risk factors for postoperative pulmonary complications in pediatric patients undergoing malignant tumor resection
10.3760/cma.j.cn131073.20240104.00907
- VernacularTitle:恶性肿瘤切除术患儿术后肺部并发症的危险因素
- Author:
Xiaodie ZHANG
1
;
Jialian ZHAO
;
Wenyang WANG
;
Binbin CAI
;
Yaoqin HU
Author Information
1. 浙江大学医学院附属儿童医院麻醉科 国家儿童健康与疾病临床医学研究中心，杭州 310057
- Keywords:
Abdominal neoplasms;
Postoperative complications;
Lung;
Risk factors
- From:
Chinese Journal of Anesthesiology
2024;44(9):1081-1085
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for postoperative pulmonary complications (PPCs) in pediatric patients undergoing malignant tumor resection.Methods:Medical records of pediatric patients who underwent open abdominal malignant tumor resection at Children′s Hospital affiliated to Zhejiang University School of Medicine from August 2019 to July 2023, with length of hospital stay ≥48 h, were retrospectively collected. Patients were divided into PPC group and non-PPC group based on the occurrence of PPCs within 7 days postoperatively. Variables with P<0.05 in the univariate analysis were included in the binary logistic regression analysis to identify the risk factors for PPCs. Results:A total of 605 pediatric patients who underwent abdominal malignant tumor resection were finally included, among which 391 children developed PPCs, with an incidence of 64.6%. Binary logistic regression analysis showed that body weight ( P=0.001), American Society of Anesthesiologists Physical Status classification ( P<0.001), preoperative hypoalbuminemia ( P=0.013), preoperative chemotherapy ( P=0.003), tumor compression/encasement of major abdominal vessels ( P=0.002), anesthesia duration ( P<0.001), intraoperative fluid intake (ml·kg -1·h -1, P<0.001), intraoperative use of hypotensive agents ( P=0.047), and concurrent resection of mediastinal tumors via abdominal approach ( P<0.001) were risk factors for PPCs in children undergoing malignant tumor resection. Age ( P<0.001) was identified as a protective factor for PPCs. Conclusions:Body weight, American Society of Anesthesiologists Physical Status classification, preoperative chemotherapy, preoperative hypoalbuminemia, tumor compression/encasement of major abdominal vessels, anesthesia duration, intraoperative fluid intake, intraoperative use of hypotensive agents, and concurrent resection of mediastinal tumors via abdominal approach are risk factors for PPCs in pediatric patients undergoing open abdominal malignant tumor resection, whereas age is a protective factor for PPCs.
