Impact of Theater Recovery Time on the Incidence of Postoperative Pneumonia in Patients Undergoing Major Lung Resection

TL;DR

The study explores whether longer recovery times in the operating room after lung surgery are linked to a higher risk of postoperative pneumonia.

Contribution

The paper investigates recovery time as a potential marker for postoperative pneumonia risk after major lung surgery.

Findings

Patients with postoperative pneumonia had longer recovery times, but the difference was not statistically significant.

Recovery time distributions were more skewed for patients who developed pneumonia.

No significant association was found between recovery time and pneumonia in patients with extended recovery periods.

Abstract

Background and hypothesis

Postoperative pneumonia (POP) is a significant cause of morbidity and mortality following thoracic surgery and across various surgical specialties. We hypothesized that increased time spent in postoperative theater recovery may be associated with a higher incidence of POP and could serve as a potential marker for identifying vulnerable patients.

Method

Data on postoperative recovery time and subsequent POP diagnosis were obtained from an automated departmental database. A total of 577 patients who underwent lobectomy, bi-lobectomy, or pneumonectomy for non-small cell lung cancer between January 2019 and October 2021 were included in this study. A power calculation (beta = 0.2, power = 0.8) indicated a required sample size of at least 360 patients. Data analysis was performed using Microsoft Excel (Microsoft Corp., Redmond, WA, US) and IBM SPSS Statistics for Windows (IBM Corp., Armonk, NY, US).

Results

The data showed that patients diagnosed with POP spent a mean of 21 minutes 23 seconds longer in the theater recovery compared to those without POP; however, this difference did not reach statistical significance (p = 0.204). The distribution of recovery times was more skewed among POP patients (skewness = 3.68) compared to non-POP patients (skewness = 1.33). This prompted further analysis focused on patients who spent more than seven hours in postoperative recovery; again, no statistically significant difference was found between POP and non-POP patients (p = 0.224).

Conclusion

Although statistical significance was not demonstrated in this study, prolonged recovery time may still reflect an underlying vulnerability to POP, or it may simply represent inefficiencies in postoperative patient flow.

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