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. 2020 Jan 7;20(1):8.
doi: 10.1186/s12871-019-0923-3.

Predictive risk factors for postoperative pneumonia after heart transplantation

Charles Vidal  1   2 , Romain Pasqualotto  3 , Arthur James  3 , Pauline Dureau  3 , Julie Rasata  3 , Guillaume Coutance  4 , Shaida Varnous  4 , Pascal Leprince  4 , Julien Amour  3 , Adrien Bouglé  3
Affiliations

Predictive risk factors for postoperative pneumonia after heart transplantation

Charles Vidal et al. BMC Anesthesiol. .

Abstract

Background: Pneumonia is a frequent complication in patients undergoing heart transplantation (HTx) that increases morbidity and mortality in this population. Nevertheless, the risk factors for postoperative pneumonia (POP) are still unknown. The aim of this study was to investigate the predictive risk factors for POP in HTx recipients.

Methods: In this retrospective study, all patients undergoing HTx between January 2014 and December 2015 were included. All cases of POP occurring until hospital discharge were investigated. The study aimed to determine risk factors using univariate and multivariate Cox regression models. Data are expressed in Odds Ratio [95% CI]. P < 0.05 was necessary to reject the null hypothesis.

Results: A total of 175 patients were included without any patients being lost to follow-up, and 89 instances of POP were diagnosed in 59 (34%) patients. Enterobacteriaceae and Pseudomonas aeruginosa were the most common pathogens. In the multivariate analysis, the risk factors were preoperative mechanical ventilation (OR 1.42 [1.12-1.80], P < 0.01) and perioperative blood transfusion (OR 1.42 [95% CI: 1.20-1.70], P < 0.01). POP significantly impacted mortality at 30 days (OR: 4 [1.3-12.4], P = 0.01) and 1 year (OR: 6.8 [2.5-8.4], P < 0.01) and was associated with a longer duration of mechanical ventilation, time to weaning from venoarterial extracorporeal membrane oxygenation and stay in an intensive care unit. Plasma exchanges and intravenous administration of immunoglobulins did not increase the risk of POP.

Conclusion: After HTx, preoperative mechanical ventilation and blood transfusion were risk factors for POP and were associated with increased mortality. Enterobacteriaceae and Pseudomonas aeruginosa are the most common pathogens of POP.

Keywords: Heart transplantation; Mechanical ventilation; Pneumonia; Sensitized recipient; Transfusion.

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Conflict of interest statement

The authors declare that they have no competing interests. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. No disclosure was reported and all authors confirmed that they have no financial relationships with companies or relevant entities that make products pertinent to the paper.

Figures

Fig. 1
Fig. 1
One-year survival curve of HTx recipients with and without postoperative pneumonia (POP), respectively 95% versus 73%, p < 0.01
See this image and copyright information in PMC

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