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Risk Factors and Prognosis of Pulmonary Complications After Endoscopic Submucosal Dissection for Gastric Neoplasia

 Chan Hyuk Park  ;  Hyunzu Kim  ;  Young Ae Kang  ;  In Rae Cho  ;  Bun Kim  ;  Su Jin Heo  ;  Suji Shin  ;  Hyuk Lee  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Yong Chan Lee  ;  Sang Kil Lee 
 DIGESTIVE DISEASES AND SCIENCES, Vol.58(2) : 540-546, 2013 
Journal Title
Issue Date
Adenoma/surgery* ; Aged ; Anti-Bacterial Agents/therapeutic use ; Comorbidity ; Cross Infection/diagnostic imaging ; Cross Infection/drug therapy ; Cross Infection/epidemiology* ; Dissection/adverse effects ; Endoscopy/adverse effects* ; Female ; Gastric Mucosa/surgery ; Gastroscopy/adverse effects ; Humans ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Pneumonia, Aspiration/diagnostic imaging ; Pneumonia, Aspiration/drug therapy ; Pneumonia, Aspiration/epidemiology* ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/drug therapy ; Postoperative Complications/epidemiology* ; Prognosis ; Radiography ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/surgery*
Endoscopic submucosal dissection ; Propofol ; Sedation ; Aspiration pneumonia
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Bun(김번)
Kim, Hyun Zu(김현주B)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Chan Hyuk(박찬혁)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Cho, In Rae(조인래)
Heo, Su Jin(허수진) ORCID logo https://orcid.org/0000-0002-0615-5869
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