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

 Chan Hyuk Park  ;  Hyunzu Kim  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Sung Kwan Shin  ;  Jun Chul Park  ;  Hyuk Lee  ;  Suji Shin  ;  Su Jin Heo  ;  Bun Kim  ;  In Rae Cho  ;  Young Ae Kang 
 Digestive Diseases and Sciences, Vol.58(2) : 540-546, 2013 
Journal Title
 Digestive Diseases and Sciences 
Issue Date
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. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
Yonsei Authors
강영애(Kang, Young Ae) ; 김번(Kim, Bun) ; 김현주(Kim, Hyun Joo) ; 박준철(Park, Jun Chul) ; 박찬혁(Park, Chan Hyuk) ; 신성관(Shin, Sung Kwan) ; 이상길(Lee, Sang Kil) ; 이용찬(Lee, Yong Chan) ; 이혁(Lee, Hyuk) ; 조인래(Cho, In Rae) ; 허수진(Heo, Su Jin)
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