Risk factors for pneumonia after radical gastrectomy for gastric cancer: A systematic review and meta-analysis

Abstract Objective The objective is to systematically gather the relevant research to determine and quantify the risk factors for pneumonia after a radical gastrectomy for gastric cancer. Methods The reporting procedures of this meta-analysis conformed to the PRISMA 2020. Chinese Wan Fang data, Chinese National Knowledge Infrastructure (CNKI), Chinese Periodical Full-text Database (VIP), Embase, Scopus, CINAHL, Ovid MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, and Scopus from the time of inception to January 20, 2024, data were systematically searched for cohort or case-control studies that reported particular risk factors for pneumonia after radical gastrectomy for gastric cancer. The quality was assessed using the Newcastle-Ottawa Scale after the chosen studies had been screened and the data retrieved. Rev Man 5.4 was the program used to perform the meta-analysis. Results Our study included data from 27,840 individuals across 27 trials. Fifteen risk factors were statistically significant, according to pooled analyses. Several factors were identified to be strong risk factors (OR: 2.21–4.72), including smoking history, prolonged postoperative nasogastric tube retention, intraoperative bleeding ≥ 200 ml, diabetes mellitus, male gender, total gastrectomy, COPD, impaired respiratory function, D2 lymphadenectomy, perioperative blood transfusion, and hypertension. Moderate risk factors included excessive surgery duration, advanced age, nutritional status, and history of pulmonary disease (OR: 1.51–1.91). Conclusions The study identified 15 independent risk factors significantly associated with pneumonia after radical gastrectomy for gastric cancer. These results offer evidence-based procedures for putting into practice successful preventive interventions.