Older age, male sex, underweight status, reduced activities of daily living, and mild consciousness disturbance were associated with postextubation pneumonia in elective surgical patients.
To compare the incidence of postextubation pneumonia and ventilator-associated pneumonia among patients undergoing elective surgery under general anesthesia.
Key Findings:
212 cases of postextubation pneumonia were identified, compared to 27 cases of ventilator-associated pneumonia.
The incidence of postextubation pneumonia was 0.67%, lower than previously reported estimates in critically ill populations.
80% of postextubation pneumonia cases developed within 1 week following extubation.
Older age, male sex, BMI below 18.5, reduced Barthel Index scores, and consciousness disturbance were independently associated with postextubation pneumonia.
Gastrointestinal and cervical procedures had about four times the odds of postextubation pneumonia.
Interpretation:
Postextubation pneumonia is a distinct clinical entity that may require different prevention strategies compared to ventilator-associated pneumonia.
Limitations:
Retrospective, single-center design and reliance on claims-based pneumonia diagnoses.
Swallowing function was not directly assessed.
Incomplete data on nasogastric tube use, tracheostomy, and other relevant factors.
Findings may not be generalizable to emergency surgery or settings outside Japan.
Conclusion:
Standardized definitions and targeted prevention strategies are needed for postextubation pneumonia.
