Analysis of risk factors for postoperative pneumonia following esophagectomy for esophageal cancer
- VernacularTitle:食管癌术后肺部感染发生的危险因素分析
- Author:
Shan LI
1
;
Xiaoqing LI
1
;
Xinyi YE
1
;
Na WU
2
;
Sicheng ZHOU
2
;
Yang HU
2
Author Information
1. Endoscopy Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
surgery;
postoperative pneumonia;
prediction;
systemic immune-inflammation index;
prognostic nutritional index;
forced expiratory volume in 1 second percentage of predicted (FEV1%)
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(08):1222-1227
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for postoperative pneumonia (POP) following esophagectomy for esophageal cancer, and to identify potential clinical indicators for predicting POP. Methods A retrospective analysis was conducted on the clinical data of patients with esophageal cancer who underwent esophagectomy at the Department of Thoracic Surgery, West China Hospital of Sichuan University from 2017 to 2021. Perioperative clinical indicators were collected to analyze the risk factors for the occurrence of POP. Patients were divided into a POP group and a non-POP group according to whether POP occurred. Results A total of 613 patients with esophageal cancer were included, comprising 472 males and 141 females, with a median age of 62.0 (53.0, 67.0) years. Among them, 51 patients were in the POP group, and 562 patients were in the non-POP group. Multivariate logistic regression analysis showed that the forced expiratory volume in 1 second percentage of predicted (FEV1%) [OR=0.958, 95%CI (0.943, 0.973), P<0.001], systemic immune-inflammation index (SII) [OR=1.001, 95%CI (1.000, 1.002), P=0.007], and prognostic nutritional index (PNI) [OR=0.869, 95% CI (0.813, 0.928), P<0.001] were independent risk factors for POP. Receiver operating characteristic (ROC) curve analysis combining FEV1%, SII, and PNI demonstrated that the area under the curve (AUC) for predicting POP was 0.826 [95%CI (0.793, 0.855), cut-off value: 0.08, sensitivity: 80.3%, specificity: 72.4%, Youden index: 0.528, P<0.001]. Cross-validation confirmed that the combined indicators had the highest predictive efficacy, which was significantly superior to that of any single indicator alone. Conclusion Preoperative levels of FEV1%, SII, and PNI are closely associated with the occurrence of POP following surgery for esophageal cancer. The combined application of FEV1%, SII, and PNI demonstrates good predictive efficacy for the occurrence of POP.
