Cardiothoracic & vascular anesthesia
Preoperative and Intraoperative Risk Factors for Postoperative Pneumonia After Cardiac Surgery: An Ancillary Study of the STERNOCAT (Catheter Outcomes With Sternotomy Cardiac Operated) Randomized Trial and a Systematic Review With Meta-Analysis
Authors' conclusion
This study highlights the difficulty of predicting and preventing POP, as most identified risk factors are non-modifiable or require long-term preventive strategies.
Study context
- Population
- Adults undergoing cardiac surgery (STERNOCAT cohort, France; Systematic review (SR) studies, international)STERNOCAT cohort
- Participants
- 1,470 adults
- Outcome
- POP risk factors (STERNOCAT cohort)
Methodological detailsexternal validation of predictive models
- External validation of predictive models
Pooled result
As reported in the abstract
Postoperative pneumonia (POP) incidence: 78 of 1470 patients
5.3%
Ischemic cardiomyopathy, OR
1.89
95% CI 1.13–3.16
Cardiopulmonary bypass (CPB) duration, OR
1.10
95% CI 1.02–1.18
Catecholamine use, OR
4.07
95% CI 2.45–6.76
Further pooled results
30-day mortality, POP vs no POP
- Higher 30-day mortality with POP: 14.1% vs. 1.5%, p < 0.0001
Meta-analysis of POP risk factors
- Significant risk factors for POP
- 14
- Non-modifiable (e.g., age, DM, COPD, chronic renal disease, previous cardiac surgery, emergency surgery)
- 10
- Partially modifiable: active smoking, CPB duration, intraoperative transfusions (presence and amount)
- Four
External validation of predictive models
- Only one model (preoperative variables only) could be externally validated; poor accuracy
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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