Related factors affecting postoperative pneumonia in patients with cavernous cerebrovascular malformation

Abstract

Objective To explore the related factors affecting postoperative pneumonia in patients with cavernous cerebrovascular malformation (CCM). Methods Clinical data of 151 CCM patients admitted to our hospital from January 2010 to January 2017 were retrospectively collected. Patients were divided into postoperative pneumonia group (n=11) and postoperative non-pneumonia group (n=140) according to the occurrence of postoperative pneumonia. Univariate Logistic regression analysis, multivariate Logistic regression analysis and receiver operating characteristic (ROC) curve were used to screen the relevant factors influencing the occurrence of postoperative pneumonia in CCM patients and evaluate the predictive value of relevant factors in postoperative pneumonia. Results As compared with patients from postoperative non-pneumonia group, patients from postoperative pneumonia group had significantly increased modified Rankin scale (mRS) scores and significantly higher percentage of CCM combined with hemorrhage, and significantly decreased Glasgow coma scale (GCS) scores (P<0.05). Multivariate Logistic regression analysis showed that preoperative GCS scores (OR=4.75, 95%CI: 1.14-19.80, P=0.032) and mRS scores (OR=15.61, 95%CI: 3.22-75.58, P=0.001) were independent factors influencing the occurrence of postoperative pneumonia. ROC curve showed that the sensitivity and specificity of mRS scores≥4 to predict postoperative pneumonia were 45.5% and 95.7%, respectively, and the sensitivity and specificity of GCS scores≤13 to predict postoperative pneumonia were 54.5% and 85.7%, respectively. Conclusion For CCM patients with preoperative GCS scores≤13 or mRS scores≥4, more attention should be paid to perioperative lung management and occurrence of postoperative pneumonia should be vigilant. Key words: Cerebral cavernous malformation; Postoperative pneumonia; Modified Rankin scale; Glasgow coma scale