Developing pneumonia after surgery for colorectal cancer (CRC) poses significant threats to patient outcomes—but new research offers improved ways to predict risk. A recent study from the First Affiliated Hospital of Chongqing Medical University reveals independent factors influencing this complication and presents a nomogram to aid surgeons in personalized patient management.
Colorectal cancer, as noted by Global Cancer Statistics 2020, is the third most diagnosed cancer globally, accounting for about 10% of new cases. It also stands as the second leading cause of cancer fatalities, with approximately 153,020 diagnoses and 52,550 expected deaths anticipated this year alone. Surgical intervention remains the cornerstone for CRC treatment, and even as surgical advancements have reduced overall postoperative complications, pneumonia persists as a serious concern.
Retrospective analysis of 7,130 CRC patients who underwent radical surgery between January 2011 to December 2021 established key insights. Researchers divided the data, using 4,994 patients for training and 2,136 for validation. Utilizing multivariate logistic regression, the study identified five independent risk factors correlated with pneumonia development: patient age, sex, preoperative albumin levels, surgical methods, and surgical duration.
Age emerged as the most telling factor—older patients had heightened vulnerability, likely due to deterioration of lung function and immune response over time. Similarly, sex differences indicated men were at higher risk, potentially due to lifestyle influences and health disparities impacting recovery. Preoperative albumin also played a significant role; lower levels suggested diminished organ reserve, impairing the ability to endure surgery.
The comparison of open vs. laparoscopic surgical methods unveiled notable differences; open surgery correlated with higher postoperative pneumonia rates, likely caused by pain inhibiting coughing and mucus clearance, allowing for secretions to accumulate and increase infection risk. Prolonged surgical times also raised pneumonia probabilities, possibly due to prolonged anesthesia effects.
The culmination of these findings is the developed nomogram—a visual representation compiling the identified risk factors to forecast pneumonia likelihood post-surgery. Validation showed the nomogram's area under the curve (AUC) was 0.745 for the training cohort and rose to 0.773 for the validation cohort, indicating high predictive accuracy.
Researchers assert this nomogram will prove invaluable for clinicians, offering data-driven insights to refine perioperative management and mitigate pneumonia risks. The research draws attention not only to the operational complexity of CRC surgeries but also emphasizes the importance of recognizing patient-specific factors.
Though promising, the findings stem from one institution and warrant scrutiny for wider applicability. Future research will ideally extend to multicenter, prospective studies, enhancing the robustness of the nomogram’s predictive powers and examining long-term outcomes for CRC patients.
The development of this predictive tool opens new avenues for improving surgical results. Continuing to refine and adapt care protocols based on individual risk factors could significantly shift perception and response to pneumonia risks, enhancing overall patient survival and recovery.