Risk factors and prognosis of pulmonary complications after endoscopic submucosal dissection for gastric neoplasia

Chan Hyuk Park, Hyunzu Kim, youngae kang, In Rae Cho, Bun Kim, Su Jin Heo, Suji Shin, Hyuk Lee, Jun Chul Park, Sung Kwan Shin, Yongchan Lee, SangKil Lee

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33 Citations (Scopus)

Abstract

Background: Hospital-acquired pneumonia after an endoscopic submucosal dissection (ESD) can prolong the patient's stay in the hospital, leading to greater healthcare costs. However, little is known of the characteristics and risk factors associated with this complication. Aims: To analyze the clinical features of pneumonia after ESD and to suggest a treatment plan. Methods: This was a retrospective study in which the cases of 1,661 consecutive patients who underwent ESD for 1,725 lesions between January 2008 and June 2011 were reviewed. Results: Of the 1,661 patients who underwent ESD during the study period, 38 were subsequently diagnosed with pneumonia, and an additional 18 patients exhibited lung consolidation, based on chest radiography, without respiratory signs or symptoms. The remaining 1,605 patients showed neither lung consolidation on chest radiography nor respiratory signs/symptoms. Continuous propofol infusion with intermittent or continuous administration of an opioid [odds ratio (OR) 4.498, 95 % confidence interval (CI) 2.267-8.923], a procedure time of >2 h (OR 2.900, 95 % CI 1.307-6.439), male gender (OR 2.835, 95 % CI 1.164-6.909), and age >75 years (OR 2.765, 95 % CI 1.224-6.249) were independent risk factors for pneumonia after ESD. In patients with only lung consolidation (without respiratory signs and symptoms), the length of hospital stay and prognosis were not affected by antibiotics use. Conclusions: Deep sedation under continuous propofol infusion with opioid injection during ESD may be a risk factor for pneumonia.

Original languageEnglish
Pages (from-to)540-546
Number of pages7
JournalDigestive Diseases and Sciences
Volume58
Issue number2
DOIs
Publication statusPublished - 2013 Feb 1

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Stomach
Respiratory Signs and Symptoms
Pneumonia
Lung
Odds Ratio
Confidence Intervals
Length of Stay
Neoplasms
Propofol
Radiography
Opioid Analgesics
Thorax
Deep Sedation
Health Care Costs
Endoscopic Mucosal Resection
Retrospective Studies
Anti-Bacterial Agents
Injections
Therapeutics

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

Park, Chan Hyuk ; Kim, Hyunzu ; kang, youngae ; Cho, In Rae ; Kim, Bun ; Heo, Su Jin ; Shin, Suji ; Lee, Hyuk ; Park, Jun Chul ; Shin, Sung Kwan ; Lee, Yongchan ; Lee, SangKil. / Risk factors and prognosis of pulmonary complications after endoscopic submucosal dissection for gastric neoplasia. In: Digestive Diseases and Sciences. 2013 ; Vol. 58, No. 2. pp. 540-546.
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abstract = "Background: Hospital-acquired pneumonia after an endoscopic submucosal dissection (ESD) can prolong the patient's stay in the hospital, leading to greater healthcare costs. However, little is known of the characteristics and risk factors associated with this complication. Aims: To analyze the clinical features of pneumonia after ESD and to suggest a treatment plan. Methods: This was a retrospective study in which the cases of 1,661 consecutive patients who underwent ESD for 1,725 lesions between January 2008 and June 2011 were reviewed. Results: Of the 1,661 patients who underwent ESD during the study period, 38 were subsequently diagnosed with pneumonia, and an additional 18 patients exhibited lung consolidation, based on chest radiography, without respiratory signs or symptoms. The remaining 1,605 patients showed neither lung consolidation on chest radiography nor respiratory signs/symptoms. Continuous propofol infusion with intermittent or continuous administration of an opioid [odds ratio (OR) 4.498, 95 {\%} confidence interval (CI) 2.267-8.923], a procedure time of >2 h (OR 2.900, 95 {\%} CI 1.307-6.439), male gender (OR 2.835, 95 {\%} CI 1.164-6.909), and age >75 years (OR 2.765, 95 {\%} CI 1.224-6.249) were independent risk factors for pneumonia after ESD. In patients with only lung consolidation (without respiratory signs and symptoms), the length of hospital stay and prognosis were not affected by antibiotics use. Conclusions: Deep sedation under continuous propofol infusion with opioid injection during ESD may be a risk factor for pneumonia.",
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Risk factors and prognosis of pulmonary complications after endoscopic submucosal dissection for gastric neoplasia. / Park, Chan Hyuk; Kim, Hyunzu; kang, youngae; Cho, In Rae; Kim, Bun; Heo, Su Jin; Shin, Suji; Lee, Hyuk; Park, Jun Chul; Shin, Sung Kwan; Lee, Yongchan; Lee, SangKil.

In: Digestive Diseases and Sciences, Vol. 58, No. 2, 01.02.2013, p. 540-546.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors and prognosis of pulmonary complications after endoscopic submucosal dissection for gastric neoplasia

AU - Park, Chan Hyuk

AU - Kim, Hyunzu

AU - kang, youngae

AU - Cho, In Rae

AU - Kim, Bun

AU - Heo, Su Jin

AU - Shin, Suji

AU - Lee, Hyuk

AU - Park, Jun Chul

AU - Shin, Sung Kwan

AU - Lee, Yongchan

AU - Lee, SangKil

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Background: Hospital-acquired pneumonia after an endoscopic submucosal dissection (ESD) can prolong the patient's stay in the hospital, leading to greater healthcare costs. However, little is known of the characteristics and risk factors associated with this complication. Aims: To analyze the clinical features of pneumonia after ESD and to suggest a treatment plan. Methods: This was a retrospective study in which the cases of 1,661 consecutive patients who underwent ESD for 1,725 lesions between January 2008 and June 2011 were reviewed. Results: Of the 1,661 patients who underwent ESD during the study period, 38 were subsequently diagnosed with pneumonia, and an additional 18 patients exhibited lung consolidation, based on chest radiography, without respiratory signs or symptoms. The remaining 1,605 patients showed neither lung consolidation on chest radiography nor respiratory signs/symptoms. Continuous propofol infusion with intermittent or continuous administration of an opioid [odds ratio (OR) 4.498, 95 % confidence interval (CI) 2.267-8.923], a procedure time of >2 h (OR 2.900, 95 % CI 1.307-6.439), male gender (OR 2.835, 95 % CI 1.164-6.909), and age >75 years (OR 2.765, 95 % CI 1.224-6.249) were independent risk factors for pneumonia after ESD. In patients with only lung consolidation (without respiratory signs and symptoms), the length of hospital stay and prognosis were not affected by antibiotics use. Conclusions: Deep sedation under continuous propofol infusion with opioid injection during ESD may be a risk factor for pneumonia.

AB - Background: Hospital-acquired pneumonia after an endoscopic submucosal dissection (ESD) can prolong the patient's stay in the hospital, leading to greater healthcare costs. However, little is known of the characteristics and risk factors associated with this complication. Aims: To analyze the clinical features of pneumonia after ESD and to suggest a treatment plan. Methods: This was a retrospective study in which the cases of 1,661 consecutive patients who underwent ESD for 1,725 lesions between January 2008 and June 2011 were reviewed. Results: Of the 1,661 patients who underwent ESD during the study period, 38 were subsequently diagnosed with pneumonia, and an additional 18 patients exhibited lung consolidation, based on chest radiography, without respiratory signs or symptoms. The remaining 1,605 patients showed neither lung consolidation on chest radiography nor respiratory signs/symptoms. Continuous propofol infusion with intermittent or continuous administration of an opioid [odds ratio (OR) 4.498, 95 % confidence interval (CI) 2.267-8.923], a procedure time of >2 h (OR 2.900, 95 % CI 1.307-6.439), male gender (OR 2.835, 95 % CI 1.164-6.909), and age >75 years (OR 2.765, 95 % CI 1.224-6.249) were independent risk factors for pneumonia after ESD. In patients with only lung consolidation (without respiratory signs and symptoms), the length of hospital stay and prognosis were not affected by antibiotics use. Conclusions: Deep sedation under continuous propofol infusion with opioid injection during ESD may be a risk factor for pneumonia.

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