Incidence and Associated Factors of Postoperative Pulmonary Complications after Abdominal Surgery in the Public Hospital, Addis Ababa, Ethiopia

Abstract

Background. Postoperative pulmonary complications are a wide variety of disorders that affect normal respiratory functions, which in turn lead to morbidity and mortality. The extent to which it occurs is not yet studied in most clinical settings. This study assessed the incidence and risk factors of postoperative pulmonary complications in patients undergoing abdominal surgery under general anesthesia. Methods. A multicenter, prospective cross-sectional study was conducted at Menelik II, Tikur Anbessa Specialized, Zewditu Memorial, and Yekatit 12 Memorial hospitals after obtaining ethical clearance from each hospital. The study recruited a total of 287 participants using systematic random sampling. The data collection tool included sociodemographic, surgical, and anesthetic factors. Participants were followed for 7 days postoperatively, and any respiratory problems were recorded once identified. The collected data were entered and analyzed using SPSS version 26. Both bivariate and multivariate logistic regressions were used for analysis. A p value of <0.05 was considered statistically significant. Results. About 33% of the participants that underwent abdominal surgery developed postoperative pulmonary complications. Age > 65 years (AOR = 12.091, 95% CI = 3.310–44.169), duration of surgery >3 hours (AOR = 11.737, 95% CI = 3.621–38.039), preoperative oxygen saturation <94% (AOR = 10.671, 95% CI = 3.794–30.016), and postoperative serum albumin level <3.5 g/dl ( p value <0.001) were associated with postoperative pulmonary complications significantly. Conclusion and Recommendations. The incidence of postoperative pulmonary complications after abdominal surgeries was high. Age >65years, duration of surgery >3 hours, preoperative SpO2% <94%, cigarette smoking, and postoperative serum albumin level <3.5 g/dl were factors strongly associated with postoperative pulmonary complications. We recommend special care for elderly patients, limit the surgical duration to less than 3 hours, treat the underlying cause of desaturation, and correct postoperative serum albumin to prevent the occurrence of postoperative pulmonary complications.

Post-operative pulmonary complications after thoracic and upper abdominal procedures at referral hospitals in Amhara region, Ethiopia: a multi-center study

“…Our study revealed that the risk of developing PPC was higher in patients with a postoperative albumin level less than 3.5 g/dl compared to those with a postoperative albumin level greater than 3.5 g/dl. This finding was in agreement with other studies ( 24 , 34 ). This could be due to a low blood protein level, which results in vascular endothelial dysfunction, or by reducing colloid osmotic pressure.…”

“…The reasons may be that the prolonged operation duration means prolonged anesthesia time that depresses movements of inter-costal muscles, alters the shape and motion of the chest wall, and diminishes ribcage excursion, affecting lung mechanics and resulting in a decrease in functional residual capacity ( 35 ). In our study, patients with prolonged surgical times were more likely to develop PPC than those whose surgeries lasted less than 2 h, which was consistent with previous studies ( 27 , 31 , 34 ).…”

“…Patients with preoperative Spo 2 < 94% were more likely to develop PPC than patients with preoperative Spo 2 ≥ 94% and this finding is in agreement with similar studies ( 24 , 31 , 34 ). A longer duration of surgery was associated with PPC.…”

Postoperative Respiratory Complications and Clinical Outcome among Patients Undergoing Upper Gastrointestinal Tumor Surgery: A Systematic Review and Meta-analysis

“…Treatment and prognosis depends on the location of the tumor, its stage and the type of cancer cell. 2 Postoperative respiratory complications are frequent events that occur in high-risk patients.…”