A retrospective nationwide analysis of factors associated with aspiration pneumonia following colorectal cancer surgery

Background Aspiration pneumonia (AP) has been established as a severe in-hospital complication following abdominal surgery. Despite its clinical significance, the incidence of and factors associated with AP after colorectal cancer surgery remain largely understudied in broad national patient cohorts. Methods This retrospective study employed data from the National Inpatient Sample (NIS) to evaluate a cohort of 57,275 colorectal cancer surgery patients from 2016 to 2019. Our analysis examined key aspects, including patient demographics, hospital characteristics, pre-existing health conditions, and perioperative complications, comparing outcomes between the AP during hospitalization group and the non-AP group. Results During the period from 2016 to 2019, the overall incidence of AP during hospitalization among patients undergoing colorectal cancer surgery was found to be 1.45%. Affected individuals were predominantly elderly (≥65 years), had more comorbidities, prolonged hospitalizations, higher treatment costs, and elevated in-hospital mortality ( p < 0.001). Several factors were associated with the onset of AP, including advanced age (≥ 65 years), sepsis, endotracheal intubation and mechanical ventilation, respiratory insufficiency, postoperative ileu and others. Conclusion AP was associated with higher in-hospital mortality; however, causality cannot be established due to the observational design of this study. A significant association was identified between AP and factors such as advanced age, and postoperative medical and surgical complications. Overall, this research enhances our understanding of factors associated with AP, and may help inform future risk stratification and perioperative management strategies.