Diagnostic value of systematic bronchial aspirate on postoperative pneumonia after pulmonary resection surgery for lung cancer: a Mono center retrospective study.

OBJECTIVES: Intraoperative bacterial airway colonization seems to be associated with an increased risk of postoperative pneumonia (POP). It can be easily assessed by performing a bronchial aspirate (BA). The objective of this study is to assess the diagnostic performance of the BA to predict POP.

METHODS: We conducted a single-center retrospective observational study over a period of 10 years, from January 1st, 2011, to December 30th, 2020. The population study was patients admitted for a scheduled pulmonary resection surgery for lung cancer. Patients were classified into two populations depending on whether or not they developed a POP. A uni- and multivariable analysis was performed to identify risk factors for developing POP. The diagnostic performance of BA was represented by its sensitivity, specificity, positive and negative predictive value.

RESULTS: 1006 patients were included in the study. Uni- and multivariable analysis found that a positive BA was independently associated with a greater risk of developing POP with an odds ratio of 6.57 [4.165-10.865]; P < 0.001. Its specificity was 95%, sensitivity was 31%, positive predictive value was 66%, and negative predictive value was 81%.

CONCLUSIONS: A positive intraoperative BA is an independent risk factor for POP after lung cancer surgery. Further trials are required to validate the systematic implementation of bronchial aspirate (BA) as an early diagnostic tool for postoperative pneumonia (POP).