{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:13:54Z","timestamp":1791389634705,"version":"4.3.3"},"reference-count":7,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    Background Postoperative infectious pneumonia (PIP) is a common and serious complication following cardiothoracic surgery, including coronary artery bypass grafting (CABG), valve interventions, and thoracic oncologic procedures. It is associated with increased morbidity, prolonged intensive care unit (ICU) stay, and healthcare burden. Methods We performed a systematic review and meta-analysis according to PRISMA 2020 guidelines. Studies published between January 2021 and December 2023 were identified from PubMed, Embase, and Scopus. Eligible studies reported the incidence and\/or perioperative risk factors for PIP with odds ratios (ORs) and 95% confidence intervals (CIs). A random-effects model was used for pooled estimates. Study quality was assessed using the Newcastle-Ottawa Scale. The review was prospectively registered in PROSPERO 2025 CRD 420251057914. Available from https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251057914. Results Six high-quality cohort studies involving 4,392 patients were included. The pooled incidence of PIP was 14.8% (95% CI, 10.6%\u201319.2%). Incidence was highest after thoracic oncologic surgery (17.2%), followed by valve surgery (15.8%) and CABG (13.5%). Significant risk factors included prolonged mechanical ventilation &gt;48 hours (OR: 3.46), age &gt;70 years (OR: 2.71), chronic obstructive pulmonary disease (OR: 2.95), cardiopulmonary bypass time &gt;120 minutes (OR: 2.63), and left ventricular ejection fraction &lt;40% (OR: 2.38). Heterogeneity was moderate (I\n                    <ns3:sup>2<\/ns3:sup>\n                    = 46%) with no publication bias. Conclusions PIP remains a major postoperative concern. Identification of key risk factors enables targeted preventive strategies\u2014early extubation, pulmonary optimization, and standardized care pathways\u2014to reduce PIP incidence and improve outcomes.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.165457.1","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:00:10Z","timestamp":1750068010000},"page":"588","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Postoperative Infectious Pneumonia in Cardiothoracic Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0279-6026","authenticated-orcid":false,"given":"Said","family":"Khallikane","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachid","family":"Seddiki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam","family":"Serghini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2447-2456","DOI":"10.1097\/CM9.0000000000001715","article-title":"Clinical risk score for postoperative pneumonia following heart valve surgery.","volume":"134","author":"D Wang","year":"2021 Sep 15","journal-title":"Chinese Medical Journal."},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.911878","article-title":"Pneumonia After Cardiovascular Surgery: Incidence, Risk Factors and Interventions.","volume":"9","author":"D Wang","year":"2022 Jun 30","journal-title":"Frontiers in Cardiovascular Medicine."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1993-1993","DOI":"10.3390\/medicina59111993","article-title":"Risk Factors of Postoperative Hospital-Acquired Pneumonia in Patients Undergoing Cardiac Surgery.","volume":"59","author":"P Duchnowski","year":"2023 Nov 13","journal-title":"Medicina."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2045-2052","DOI":"10.1111\/jocs.15471","article-title":"Impact of postoperative complications after cardiac surgery on long-term survival.","volume":"36","author":"S Pahwa","year":"2021 Mar 9","journal-title":"Journal of Cardiac Surgery."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2344-2351","DOI":"10.1053\/j.jvca.2021.12.024","article-title":"Postoperative Pulmonary Complications After Cardiac Surgery: The VENICE International Cohort Study.","volume":"36","author":"M Fischer","year":"2021 Dec 1","journal-title":"Journal of Cardiothoracic and Vascular Anesthesia."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e400-e406","DOI":"10.1097\/SLA.0000000000004546","article-title":"The Complexity of Defining Postoperative Pneumonia After Esophageal Cancer Surgery: A Spectrum of Lung Injury Rather Than a Simple Infective Complication?.","volume":"276","author":"N Raftery","year":"2020 Nov 12","journal-title":"Annals of Surgery."},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.29132228.v1","author":"S Khallikane","year":"2025","journal-title":"figshare."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/14-588\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-588\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/14-588\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T04:25:09Z","timestamp":1752639909000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/14-588\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":7,"URL":"https:\/\/doi.org\/10.12688\/f1000research.165457.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.182096.r392908","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.182096.r398105","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.182096.r392908","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.182096.r398105","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/14-588\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.182096.r392908, Chlouchi Abdellatif, Military Hospital Mohammed, Rabat, 25 Jun 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/14-588\/v1#referee-response-392908","order":0,"name":"referee-response-392908","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.182096.r398105, Bastiaan M Gerritse, Amphia Hospital, Molengracht, 16 Jul 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/14-588\/v1#referee-response-398105","order":1,"name":"referee-response-398105","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}