Incidence and risk factors for pneumonia following anterior cervical decompression and fusion procedures: an ACS-NSQIP study

Abstract Background Context Postoperative pneumonia has important clinical consequences for both patients and the health-care system. Few studies have examined pneumonia following anterior cervical decompression and fusion (ACDF) procedures. Purpose This study aimed to determine the incidence and risk factors for development of pneumonia following ACDF procedures. Study Design/Setting A retrospective cohort study of data collected prospectively by the American College of Surgeons National Surgical Quality Improvement Program was carried out. Patient Sample This study comprised 11,353 patients undergoing ACDF procedures during 2011–2013. Outcome Measures The primary outcome was diagnosis of pneumonia in the first 30 postoperative days. Methods Independent risk factors for the development of pneumonia were identified using multivariate regression. Readmission rates were compared between patients who did and did not develop pneumonia using multivariate regression that adjusted for all demographic, comorbidity, and procedural characteristics. Results The incidence of pneumonia was 0.45% (95% confidence interval=0.33%–0.57%). In the multivariate analysis, independent risk factors for the development of pneumonia were greater age (p