Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Denu, Zewditu Abdissa; Yasin, Mensur Osman; Melekie, Tadesse Belayneh; Berhe, Alhazar

doi:10.4172/2155-6148.1000554

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…In our study, patients with intra-operative blood loss of >500 ml were more likely to develop PPC than patients with blood loss of less than 500 ml which was in line with previous studies ( 12 , 30 ). Excessive blood loss during surgical procedures calls for judicious replacement to restore a normovolemic state.…”

Section: Discussionsupporting

confidence: 93%

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

et al. 2023

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BackgroundThoraco-abdominal surgery cuts through muscle, disrupting the normal structure and function of the respiratory muscles, resulting in lower lung volumes and a higher risk of developing post-operative pulmonary complications (PPC). PPC remains an important cause of post-operative morbidity and mortality and impacts the long-term outcomes of patients after hospital discharge. This study was aimed at determining the incidence and factors associated with postoperative pulmonary complications among patients who underwent thoracic and upper abdominal surgery in the Amhara region of Ethiopia.MethodsA multi-center follow-up study was conducted from April 1, 2022, to June 30, 2022, at comprehensive specialized hospitals in Amhara regional state, northwest Ethiopia. 424 patients were consecutively included in this study, with a response rate of 100%. A chart review and patient interview were used to collect data. A logistic regression analysis was performed to assess the strength of the association of independent variables with postoperative pulmonary complications.The crude odds ratio (COR) and adjusted odds ratio (AOR) with the corresponding 95% confidence interval were computed. Variables with a p-value of <0.05 were considered statistically significant predictors of the outcome variable.ResultsThe incidence of postoperative pulmonary complication was 24.5%. Emergency procedures, preoperative SpO2 < 94%, duration of surgery >2 h, patients with a nasogastric tube, intraoperative blood loss >500 ml and post-operative albumin <3.5 g/dl were factors associated with pulmonary complications. The most common complications were pneumonia (9.9%) followed by respiratory infection (4.2%).ConclusionThe incidence of postoperative pulmonary complication after thoracic and upper abdominal surgery remains high. Preoperative SpO2, duration of surgery, patients having a nasogastric tube, intraoperative blood loss and post-operative albumin were factors associated with post-operative pulmonary complications.

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Section: Discussionsupporting

confidence: 93%

“…In our study, different types of pulmonary complications were identified in the post-operative period. Among those complications, pneumonia was the most common, followed by respiratory infection and respiratory failure, which is similar to other previous studies (24,(28)(29)(30).…”

Section: Discussionsupporting

confidence: 91%

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

et al. 2023

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“…A Tanzanian study found that PHRF accounted for 8.3% of morbidity and mortality [6]. In Ethiopia, a retrospective study conducted in Addis Ababa and Gondar revealed that pulmonary complications were the most common postoperative complications [7]. And in Uganda, a multicenter study conducted on 485 patients, showed 23.9% of the patients were hypoxemic within the rst 15 minutes of arriving at the post-anesthesia care unit and needed oxygen supplementation.…”

Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Postoperative Hypoxemic Respiratory Failure following Emergency Surgical Procedures at the causality theatre, Mulago National Referral Hospital.

Waswa,

Basenero,

Singura

et al. 2023

Preprint

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Introduction: Postoperative hypoxemic respiratory failure (PHRF) is a significant cause of morbidity and mortality in emergency surgery and anesthesia [1]. Identifying patients at risk for PHRF is important for better patient outcomes. There is however little data describing the burden of PHRF and its risk factors in low-resource- setting such as Uganda. This study aimed to determine the incidence, risk factors, and outcomes of postoperative hypoxemic respiratory failure following emergency surgical procedures at the causality theatre, Mulago National Referral Hospital (MNRH). Methods:Patients who underwent emergency surgery at the causality theatre of MNRH between March and April 2022 were assessed for PHRF within the first 5 days of postoperative. Background data were collected using questionnaires and medical records to assess risk factors. The patients were then followed up for 28 days post-operative to assess mortality. Analysis was done using Stata version 15 and Poisson regression was done to assess the risk factors for PHRF. Results: Out of 389 participants recruited, 345 participants had their data analyzed. 78.3% were male and the mean age of the participants was 39.0 years. 14.5% developed PHRF within the first five postoperative days which was the overall incidence of PHRF. At multivariate analysis, four factors were significantly associated with the incidence of PHRF, that is, ASA score > 2 with a ninefold risk (8.58, 3.75-19.62, p <0.001), cigarette smoking with a fourfold risk (4.20, 2.03-8.71, p<0.001), estimated blood loss of over 100mls with a threefold risk (2.5, 1.59- 4.54, p < 0.001), and presence of a nasogastric tube preoperatively with a fivefold risk (5.20, 2.31-11.69, p<0.001). The mean hospital length of stay was substantially prolonged for those with PHRF within the first five days of surgery; 13 days’ vs 5 days in those without. The overall mortality on day 28 was 1 death per 1000 days of observation in those without PHRF vs. 40 deaths per 1000 days of observation in patients who developed PHRF. Conclusions: PHRF is common within the first 5 days of post-operative with a high incidence rate of 14.5% following emergency surgery. Close monitoring of emergency surgical patients especially those with a smoking history, high blood loss, ASA score >2, or using a nasogastric tube preoperatively to allow early recognition and treatment of PHRF may reduce the risk of death.

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“…3 La disfunción pulmonar postquirúrgica (DPP) es una complicación bastante común después de una cirugía, en especial en cirugía cardiaca; 40% de los admitidos a la UCI secundario a DPP presentan insuficiencia respiratoria, y hasta el momento aún se desconoce el manejo que pueda reducir su incidencia (Tabla 1). 4,5 Las manifestaciones clínicas de la DPP incluyen derrame pleural (27-95%), atelectasia (16.6-88%), hipoxe-RESUMEn Introducción: Las complicaciones postoperatorias a nivel pulmonar son causa de morbilidad y mortalidad, particularmente cuando desarrollan síndrome de dificultad respiratoria aguda y requieren ventilación mecánica; uno de los métodos empleados para pacientes que no responden al manejo ventilatorio convencional es la posición prono; sin embargo, hay poca evidencia sobre ventilación en prono en pacientes quirúrgicos abdominales. Material y métodos: Se revisó una cohorte de pacientes ventilados en prono para analizar el comportamiento de los cortocircuitos pulmonares y el índice Pao 2 /Fio 2 antes, durante y después de la ventilación en prono.…”

Section: Introductionunclassified

“…6,7 El manejo con ventilación en posición prono está recomendado para aquéllos con relación Pao 2 /Fio 2 < o igual a 150; sobre esto se conocen en la literatura contraindicaciones absolutas y relativas, enlistándose el estado postquirúrgico de abdomen y específicamente abdomen abierto como una contraindicación relativa, sin existir un sustento objetivo y de peso para ello. [5][6][7] El objetivo de este manuscrito es describir una cohorte de pacientes postquirúrgicos con abdomen abierto que requirieron manejo ventilatorio en posición prono.…”

Section: Introductionunclassified

Ventilación en posición prono en pacientes postoperados de cirugía abdominal complicados con síndrome de dificultad respiratoria aguda: análisis de una cohorte

Hernández-López¹,

Gorordo-Delsol²,

Hernández-Romero³

et al. 2019

Medicina Crítica

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Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Cited by 6 publications

References 26 publications

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

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

Incidence, Risk Factors, and Outcomes of Postoperative Hypoxemic Respiratory Failure following Emergency Surgical Procedures at the causality theatre, Mulago National Referral Hospital.

Ventilación en posición prono en pacientes postoperados de cirugía abdominal complicados con síndrome de dificultad respiratoria aguda: análisis de una cohorte

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