Postoperative pulmonary complications following major elective abdominal surgery: a cohort study

Abstract

BackgroundPostoperative pulmonary complications (PPC) are an under-reported but major cause of perioperative morbidity and mortality. The aim of this prospective, contemporary, multicentre cohort study of unselected patients undergoing major elective abdominal surgery was to determine the incidence and effects of PPC.MethodsData on all major elective abdominal operations performed over a 2-week period in December 2014 were collected in six hospitals. The primary outcome measure of PPC at 7 days was used. Univariate and multivariate analyses were performed to investigate how different factors were associated with PPC and the effects of such complications.ResultsTwo hundred sixty-eight major elective abdominal operations were performed, and the internal validation showed that the data set was 99 % accurate. Thirty-two (11.9 %) PPC were reported at 7 days. PPC was more common in patients with a history of chronic obstructive pulmonary disease compared to those with no history (26.7 vs. 10.2 %, p < 0.001). PPC was not associated with other patient factors (e.g. age, gender, body mass index or other comorbidities), type/method of operation or postoperative analgesia. The risk of PPC appeared to increase with every additional minute of operating time independent of other factors (odds ratio 1.01 (95 % confidence intervals 1.00–1.02), p = 0.007). PPC significantly increase the length of hospital stay (10 vs. 3 days). Attendance to the emergency department within 30 days (27.3 vs. 10.6 %), 30-day readmission (21.7 vs. 9.9 %) and 30-day mortality (12.5 vs. 0.0 %) was higher in those with PPC.ConclusionsPPC are common and have profound effects on outcomes. Strategies need to be considered to reduce PPC.Electronic supplementary materialThe online version of this article (doi:10.1186/s13741-016-0037-0) contains supplementary material, which is available to authorized users.

Incidence, in-hospital mortality and risk factors for hospital-acquired pneumonia in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade, Serbia: A matched case- control study

“…During the study period 51 or 1.4% of surgical patients were diagnosed with HAP in the postoperative period. The overall incidence of HAP was similar to incidence reported in the study of Delagdo-Rodriguez et al 15 , but lower than that reported in studies of Mohri et al 7 , Thompson et al 8 , and Patel et al 9 . These differences could be related to differences in type of operative procedures conducted, characteristics of hospital populations studied, and surveillance methods used.…”

“…HAP in patients undergoing intra-abdominal surgical procedures causes significant morbidity and mortality and prolongs hospital stays 8,9 . In this study we analyzed postoperative HAP in large cohort of intra-abdominal surgical patients.…”

“…Ventilator-associated pneumonia (VAP) refered to HAP develops among patients on mechanical ventilators (MV) and presents more than 48 hours after endotracheal intubation 6 . HAP in surgical population significantly increases morbidity and mortality, prolonging hospitalization and increasing total treatment costs [7][8][9][10] . Surveillance of HAP provides useful data in identifying risk factors (RF) that contribute to the development and outcome of HAP.…”

Monitorização de complicações pós-operatórias no ambiente domiciliar

“…O destaque para as complicações pulmonares no pós-operatório ocorre pelo fato de estas serem comuns a uma série de especialidades cirúrgicas, tendo como principais representantes a pneumonia, atelectasia, insuficiência respiratória e tromboembolismo pulmonar, apontadas também em nosso estudo. As complicações que fazem parte desse grupo possuem incidência variando de 5 a 35,0% segundo dados recentes de estudos multicêntricos, com elevada mortalidade, em torno de 30,0%, devido ao agravamento do quadro clínico com rapidez (13)(14) .…”

Pulmonary complications after non-cardiac surgeries: temporal patterns and risk factors

“…After abdominal surgery, the incidence of POPCs increases substantially [9]. Patel et al [10] reported an 11.9% incidence of POPCs following elective major abdominal surgery.…”