Pediatric anesthesia & critical care
Innate Biological Vulnerability: Male Sex as an Independent Risk Factor for Postoperative Pulmonary Complications in Infants Undergoing One-lung Ventilation
Authors' conclusion
Male sex is associated with a 2.5-fold increase in PPC risk that persisted after adjusting for surgical complexity and perioperative course.
Study context
- Population
- Infants undergoing elective video-assisted thoracic surgery lung resection with OLV, single high-volume tertiary pediatric centre, 2018–2023median age 6 months
- Participants
- 547 infants
- Exposure
- Male vs female sex
- Outcome
- PPCs (respiratory failure, pneumonia, prolonged air leak, therapeutic bronchoscopy for atelectasis)
Methodological detailssingle-centre, multivariable logistic regression, 1:1 propensity-score matched sensitivity analysis, postoperative pulmonary complications (PPCs) adjudicated by two independent clinicians blinded to sex
- Single-centre
- Multivariable logistic regression
- 1:1 propensity-score matched sensitivity analysis
- PPCs adjudicated by two independent clinicians blinded to sex
Main finding
As reported in the abstract
PPCs
Boys vs GirlsAbsolute risk difference (95% CI)
Crude
13%(7–19)
Boys vs GirlsAdjusted odds ratio (95% CI)P value
Age-adjusted model; aOR range 2.28-2.49 across six models, all p ≤ 0.002
2.31(1.36–3.93)
P = 0.002- Overall PPC incidence
- 17.4% (95% CI, 14.3-20.8)
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| PPCs after 1:1 propensity-score matchingn = 190 matched · propensity-score matched | 2.34 (1.31–4.17) | P = 0.004 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Effect modification of sex–PPC association
- Ventilation duration
- P for interaction = 0.755
- Surgeon experience
- P for interaction = 0.554
- Procedure type
- P for interaction = 0.612
- No effect modification
Original publication
Innate Biological Vulnerability: Male Sex as an Independent Risk Factor for Postoperative Pulmonary Complications in Infants Undergoing One-lung Ventilation. J Cardiothorac Vasc Anesth. Published 29 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →