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. 2019 Jul 15;20(1):154.
doi: 10.1186/s12931-019-1128-5.

Postoperative acute exacerbation of interstitial pneumonia in pulmonary and non-pulmonary surgery: a retrospective study

Takuto Miyamura  1 , Noriho Sakamoto  2 , Tomoyuki Kakugawa  1 , Daisuke Okuno  1 , Hirokazu Yura  1 , Shota Nakashima  1 , Hiroshi Ishimoto  1 , Takashi Kido  1 , Daisuke Taniguchi  3 , Takuro Miyazaki  3 , Tomoshi Tsuchiya  3 , Shin Tsutsui  4 , Hiroyuki Yamaguchi  1 , Yasushi Obase  1 , Yuji Ishimatsu  5 , Kazuto Ashizawa  4 , Takeshi Nagayasu  3 , Hiroshi Mukae  1
Affiliations

Postoperative acute exacerbation of interstitial pneumonia in pulmonary and non-pulmonary surgery: a retrospective study

Takuto Miyamura et al. Respir Res. .

Abstract

Background: Acute exacerbation of interstitial pneumonia (AE-IP) is a serious complication of pulmonary surgery in patients with IP. However, little is known about AE-IP after non-pulmonary surgery. The aim of this study was to determine the frequency of AE-IP after non-pulmonary surgery and identify its risk factors.

Methods: One hundred and fifty-one patients with IP who underwent pulmonary surgery and 291 who underwent non-pulmonary surgery were retrospectively investigated.

Results: AE-IP developed in 5 (3.3%) of the 151 patients in the pulmonary surgery group and 4 (1.4%) of the 291 in the non-pulmonary surgery group; the difference was not statistically significant. A logistic regression model showed that serum C-reactive protein (CRP) was a predictor of AE-IP in the non-pulmonary surgery group (odds ratio 1.187, 95% confidence interval 1.073-1.344, P = 0.002).

Conclusions: This is the first study to compare the frequency of AE-IP after pulmonary surgery with that after non-pulmonary surgery performed under the same conditions. The results suggest that the frequency of AE-IP after non-pulmonary surgery is similar to that after pulmonary surgery. A high preoperative C-reactive protein level is a potential risk factor for AE-IP after non-pulmonary surgery.

Keywords: Acute exacerbation; C-reactive protein; Interstitial pneumonia; Surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study design. A retrospective review of clinical records identified 50,394 patients who underwent surgery under general anesthesia from April 2008 to October 2017. Of these, 1789 patients had interstitial pneumonia (IP). In total, 1345 patients were excluded because they had not undergone HRCT (n = 422), did not have IP confirmed on HRCT of the chest (n = 907), were lung transplant recipients (n = 5), or underwent further surgery within 30 days of the previous surgery (n = 13), leaving data for 442 patients available for inclusion in the study. One hundred and fifty-one patients underwent pulmonary surgery and 291 underwent non-pulmonary surgery with IP
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