{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:47:56Z","timestamp":1791820076404,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Postoperative pulmonary complications (PPCs) represent the most frequent complications after lung surgery, and they increase postoperative mortality. This study investigated the incidence of PPCs, in-hospital mortality rate, and risk factors leading to PPCs in patients undergoing open thoracotomy lung resections (OTLRs) for primary lung cancer. The data from 1426 patients in this multicentre retrospective study were extracted from the German Thorax Registry and presented after univariate and multivariate statistical processing. A total of 472 patients showed at least one PPC. The presence of two PPCs was associated with a significantly increased mortality rate of 7% (p &lt; 0.001) compared to that of patients without or with a single PPC. Three or more PPCs increased the mortality rate to 33% (p &lt; 0.001). Multivariate stepwise logistic regression analysis revealed male gender (OR 1.4), age &gt; 60 years (OR 1.8), and current or previous smoking (OR 1.6), while the pre-operative risk factors were still CRP levels &gt; 3 mg\/dl (OR 1.7) and FEV1 &lt; 60% (OR 1.4). Procedural independent risk factors for PPCs were: duration of surgery exceeding 195 min (OR 1.6), the amount of intraoperative blood loss (OR 1.6), partial ligation of the pulmonary artery (OR 1.5), continuing invasive ventilation after surgery (OR 2.9), and infusion of intraoperative crystalloids exceeding 6 mL\/kg\/h (OR 1.9). The incidence of PPCs was significantly lower in patients with continuous epidural or paravertebral analgesia (OR 0.7). Optimising perioperative management by implementing continuous neuroaxial techniques and optimised fluid therapy may reduce the incidence of PPCs and associated mortality.<\/jats:p>","DOI":"10.3390\/jcm11195774","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T23:09:29Z","timestamp":1664492969000},"page":"5774","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Risk Factors for Postoperative Pulmonary Complications Leading to Increased In-Hospital Mortality in Patients Undergoing Thoracotomy for Primary Lung Cancer Resection: A Multicentre Retrospective Cohort Study of the German Thorax Registry"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6639-2938","authenticated-orcid":false,"given":"Wolfgang","family":"Baar","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Semmelmann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Knoerlein","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederike","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2942-0351","authenticated-orcid":false,"given":"Sebastian","family":"Heinrich","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Loop","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Medical Center\u2014University of Freiburg, Faculty of Medicine\u2014University of Freiburg, 79106 Freiburg, Germany"},{"name":"German Society of Anaesthesiology and Intensive Care Medicine, 10115 N\u00fcrnberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"00311","DOI":"10.1183\/23120541.00311-2021","article-title":"Lung Cancer Mortality in Europe and the USA between 2000 and 2017: An Observational Analysis","volume":"7","author":"Jani","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"234S","DOI":"10.1378\/chest.07-1378","article-title":"Treatment of Non-Small Cell Lung Cancer Stage I and Stage II: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)","volume":"132","author":"Scott","year":"2007","journal-title":"Chest"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1111\/anae.14649","article-title":"Association between Anaesthetic Technique and Unplanned Admission to Intensive Care after Thoracic Lung Resection Surgery: The Second Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) National Audit","volume":"74","author":"Shelley","year":"2019","journal-title":"Anaesthesia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.athoracsur.2012.03.054","article-title":"The Society of Thoracic Surgeons General Thoracic Surgery Database: Establishing Generalizability to National Lung Cancer Resection Outcomes","volume":"94","author":"LaPar","year":"2012","journal-title":"Ann. 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