Postoperative Pneumonia

Basics

Postoperative pneumonia (POP) is the most common postoperative complication. Depending on the type of surgery performed occurs in 9-40% of patients following abdominal surgery with an associated mortality rate of 30-46%.

 

Patients undergoing upper abdominal or thoracic surgery are particularly vulnerable to developing POP with a reported incidence of POP after upper abdominal incisions of 36.7%. The incidence of POP increases when patients undergo combined thoraco-abdominal procedures for oesophageal or gastro-oesophageal junctional (GOJ) cancers. Following an open transthoracic oesophagectomy for such tumours the incidence of POP is 57%.

 

Such complications following surgery can increase length of hospital stay by 75%, costs by 50% and have a negative impact on postoperative survival.

 

Definition of Postoperative Pneumonia

 

The Centers for Disease Control and Prevention (CDC) has a well validated definition of Postoperative Pneumonia (POP) which is cited in over 4,500 peer-reviewed publications. It defines POP as postoperative patients who met one of the following two criteria between the 2nd and 30th postoperative day:

 

Dullness to percussion on physical examination of chest

OR

Chest Radiograph showing new or progressive infiltrate, consolidation, cavitation, or pleural effusion

AND anyone of the following:

  

  • New onset of purulent sputum or change in character of sputum
  • Isolation of organism from blood culture
  • Isolation of pathogen from specimen obtained by transtracheal aspirate, bronchial brushing, or biopsy

 

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