Clinical variables of preoperative risk in thoracic surgery

Saad, Ivete Alonso Bredda; Capitani, Eduardo Mello De; Toro, Ivan Felizardo Contrera; Zambon, Lair

doi:10.1590/s1516-31802003000300004

Cited by 22 publications

(25 citation statements)

References 34 publications

(54 reference statements)

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“…In the two studies previously conducted, it was reported that the presence of cough symptom in the preoperative phase increases the PPC risk (9,10). While the only factor increasing PPC risk was purulent cough in the series mentioned before (respectively, 297 and 117 patients), in our study, in addition to cough symptom, the presence of dyspnoea, sputum and wheezing were evaluated, and the presence of a significant risk was determined.…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Saraçoğlu¹,

Yavru²,

Küçükgöncü³

et al. 2014

Turk J Anesth Reanim

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Objective: In the present study, we applied the method of the multi-center Prospective Evaluation of a Risk Score for postoperative pulmonary Complications in Europe (PERISCOPE) study, which was designed to predict postoperative complications and funded by the European Society of Anaesthesiology, to patients in our institution with the aim of prospectively analyzing the postoperative risk factors of pulmonary complications. Methods:One hundred patients over 18 years of age who had emergency or elective non-thoracic or non-obstetric surgery under general anaesthesia or neuraxial blocks were included in the study. Collected data regarding the preoperative and postoperative period were filled in separate forms for all patients.Results: A total of 11 patients developed pulmonary complications. We observed respiratory failure in 8 patients, pleural effusion in 3 patients, atelectasis in 5 patients, bronchospasm in 3 patients, and pneumothorax in 1 patient. In the univariate logistic regression model, patient age, gender, weight, rate of preoperative respiratory symptoms, cough test results, American Society of Anesthesiology (ASA) score, and the duration of surgery did not significantly increase the complication risk (p>0.05). However, in the univariate logistic regression model, the presence of respiratory symptoms increased the risk for complications approximately 5.34-fold (p=0.014). There was an increase in the possibility of complications in parallel with the increase in the duration of postoperative hospital stay (p=0.012). More respiratory symptoms (p=0.019) and longer hospital stay (6.5 vs. 3.5 days respectively, p=0.029) were recorded in patients with postoperative pulmonary complications. Conclusion:Considering patients undergoing non-thoracic or non-obstetric surgery, the prevalence of postoperative pulmonary complications is higher in patients diagnosed with respiratory symptoms in the preoperative period. These complications significantly extend the length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Saraçoğlu¹,

Yavru²,

Küçükgöncü³

et al. 2014

Turk J Anesth Reanim

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“…23 The results from this study may add to other authors' investigations, to suggest that there is no evidence that spirometry has any predictive value with regard to postoperative pulmonary complications other than what is supplied by clinical evaluation, considering the short observation period. 4,7,[23][24][25] There was no difference in measured pain during the preoperative and postoperative periods for either group, or after physiotherapy. Some patients in the chest physiotherapy group even reported some pain reduction after the exercises.…”

Section: Resultsmentioning

confidence: 80%

“…There are also falls in oxygen arterial pressure and in oxygen-hemoglobin saturation. 1,4 Postoperative pulmonary complications occur after upper abdominal surgery at a rate ranging from 6 to 70% of patients, depending on the criteria for defi ning them. 1,[5][6][7] They may include atelectasis, pneumonia or hypoxemia, among others.…”

Section: Introductionmentioning

confidence: 99%

Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial

et al. 2008

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CONTEXT AND OBJECTIVE: Abdominal surgical procedures increase pulmonary complication risks. The aim of this study was to evaluate the effectiveness of chest physiotherapy during the immediate postoperative period among patients undergoing elective upper abdominal surgery. DESIGN AND SETTING:This randomized clinical trial was performed in the post-anesthesia care unit of a public university hospital.METHODS: Thirty-one adults were randomly assigned to control (n = 16) and chest physiotherapy (n = 15) groups. Spirometry, pulse oximetry and anamneses were performed preoperatively and on the second postoperative day. A visual pain scale was applied on the second postoperative day, before and after chest physiotherapy. The chest physiotherapy group received treatment at the post-anesthesia care unit, while the controls did not. Surgery duration, length of hospital stay and postoperative pulmonary complications were gathered from patients' medical records. RESULTS:The control and chest physiotherapy groups presented decreased spirometry values after surgery but without any difference between them (forced vital capacity from 83.5 ± 17.1% to 62.7 ± 16.9% and from 95.7 ± 18.9% to 79.0 ± 26.9%, respectively). In contrast, the chest physiotherapy group presented improved oxygen-hemoglobin saturation after chest physiotherapy during the immediate postoperative period (p < 0.03) that did not last until the second postoperative day. The medical record data were similar between groups.

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“…Pulmonary complications are reported in 12 to 70% of patients who undergo upper abdominal and thoracic surgery, in comparison with a 4% incidence after urological or orthopedic surgery [10][11][12] . The prevalence of POPC observed in our sample was 18.2%.…”

Section: Discussionmentioning

confidence: 99%

Valor dos achados clínicos e da avaliação funcional pulmonar pré-operatórios como preditores das complicações pulmonares pós-operatórias

Silva¹,

Gazzana²,

Knorst³

2010

Rev. Assoc. Med. Bras.

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objectIve. To assess the relationship of clinical data and the results of preoperative pulmonary functional evaluation with postoperative pulmonary complications. Methods. We conducted a retrospective cohort study with patients who underwent pulmonary functional evaluation over a period of 5 years. We analyzed clinical, demographic and spirometric data, surgical procedures performed and postoperative pulmonary complications. results. We analyzed the medical records of 521 patients. Mean age was 59.5 ± 14 years, 65.8% were male, and 93.4% were white. Mean FEV1 was 76.6 ± 24.6% of predicted. There were clinical comorbidities in 73.5% of all cases (COPD in 29.8%). The most common surgical sites were thorax (n = 122; 23.4%) and upper abdomen (n = 117; 22.5%). Postoperative pulmonary complications occurred in 99 patients (19.0%), with respiratory failure being the most common (4.6%). Forty-three (8.3%) patients died. Rates of pulmonary complications were higher after thoracic (28.9%), cardiac (28%) and upper abdomen surgery (24.3%) (p≤0.0001). Most patients (66.7%) with pulmonary complications were classified as ASA III or IV (p<0.01), and in 70.2% of operations, time on anesthesia was > 3.5 hours (p≤0.0001). The difference in median length of hospital stay between patients with and without pulmonary complications was statistically significant (23.5 [15.8-34] days vs. 10 [6-18] days; p<0.001). Patients who had never smoked had fewer complications than those with current or past smoking history (p=0.04). We did not detect significant associations between postoperative pulmonary complications and presence of COPD, FEV1 or body mass index (p>0.05). conclusIon. The most important factors associated with postoperative pulmonary complications were surgical site, time of anesthesia, and ASA classification.

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Clinical variables of preoperative risk in thoracic surgery

Abstract: Wheezing, body mass index, smoking and surgery duration increase the chances of postoperative pulmonary complications in thoracic surgery

Cited by 22 publications

References 34 publications

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Chest physiotherapy during immediate postoperative period among patients undergoing upper abdominal surgery: randomized clinical trial

Valor dos achados clínicos e da avaliação funcional pulmonar pré-operatórios como preditores das complicações pulmonares pós-operatórias

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