Risk factors for morbidities and mortality in children following pneumonectomy

Respirology. 2017 Jan;22(1):187-191. doi: 10.1111/resp.12867. Epub 2016 Aug 10.

Abstract

Background and objective: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized.

Methods: In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities. Scoliosis, wound infection and atelectasis were considered minor morbidities.

Results: Median age at PNE was 7.4 years; 45% were males. Indications of pneumonectomy were postinfectious bronchiectasis (61%), tumours (17%), pulmonary malformations (17%), aspiration syndrome (14%), cystic fibrosis (6%), immunodeficiency (4%) and trauma (2%). Mortality rate was 4% at 1 month. Major and minor morbidities were present in 23% and 27% of patients, respectively. Risk factors for development of morbidities after PNE were age ≤ 3 years (OR: 16.7; 95% CI: 2.4-117) and the need for mechanical ventilation for at least 4 days (OR: 8; 95% CI: 1.5-43.6).

Conclusion: Children are at high risk of death, major and minor morbidities following PNE. Caution is recommended for this group of patients.

Keywords: children; morbidity; mortality; pneumonectomy; risk factors.

MeSH terms

  • Argentina / epidemiology
  • Child
  • Female
  • Humans
  • Male
  • Mortality
  • Outcome and Process Assessment, Health Care
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / methods
  • Pneumonectomy* / mortality
  • Pneumonia* / diagnosis
  • Pneumonia* / epidemiology
  • Pneumonia* / etiology
  • Pneumothorax* / diagnosis
  • Pneumothorax* / epidemiology
  • Pneumothorax* / etiology
  • Postoperative Complications* / classification
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Respiration, Artificial* / adverse effects
  • Respiration, Artificial* / statistics & numerical data
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sepsis* / diagnosis
  • Sepsis* / epidemiology
  • Sepsis* / etiology
  • Treatment Outcome