Predictors and outcomes of postoperative pulmonary complications following abdominal surgery in a South Indian population

Abstract

Background:Postoperative pulmonary complications (PPC) following abdominal surgery are associated with increased morbidity and poorer outcomes. We prospectively examined risk factors associated with the development of PPC in patients undergoing abdominal surgery.Aims:The primary outcome was to determine the association of predefined risk factors in the prediction of PPC after abdominal surgery. Secondary outcomes were evaluation of outcomes of PPC.Setting and Design:This was a prospective study conducted in the gastrosurgical and urological units of a tertiary care referral hospital in patients undergoing abdominal surgery over a period of 6 months (November 2015–April 2016).Materials and Methods:Relevant preoperative and intraoperative variables were recorded by the anesthesiologist in a pro forma provided. Postoperatively, data from the Intensive Care Unit (ICU) were collected from data sheets. PPC were defined according to preset criteria and outcomes of the patients including ICU stay, hospital stay, and mortality were noted.Statistical Analysis:Chi-square test was used to find the association of risk factors of PPC. Mann–Whitney test was used for continuous variables and McNemar's test for postoperative respiratory variables. A final regression analysis was performed with factors with significant association (P < 0.1)Results:One hundred and fifty patients were included, and 24 patients (16%) developed PPC as defined by our criteria. Emergency surgery (44.4% of PPC) and cardiac comorbidity (23.9% of PPC) were significant associations for pulmonary complications. The length of ICU and hospital stay (LOICU, LOHS) and mortality were higher in the group with pulmonary complications (P < 0.001).Conclusions:Emergent surgery and cardiac comorbidities were independent predictors for the development of PPC. PPC are associated with increased LOHS, LOICU stay, and mortality.

The Effect of High-Flow Nasal Oxygen Therapy on Postoperative Pulmonary Complications and Hospital Length of Stay in Postoperative Patients: A Systematic Review and Meta-Analysis

“…Both PPC and reintubation are associated with increased patient mortality. 52,53 Although both of them showed a downward trend in the HFNO group compared to the control group in the meta-analysis, HFNO failed to affect mortality. Mortality may not be the primary end point of the meta-analysis which may lead to biases and affect the results.…”

Root causes and outcomes of postoperative pulmonary complications after abdominal surgery: a retrospective observational cohort study

“…[24] recorded a 28.2% incidence of pulmonary complications, in patients undergoing emergency abdominal surgery. Kumar et al studied one hundred and fifty patients who underwent abdominal surgery, and of these, 16% developed PPCs and the highest incidence occurred in the emergency surgery group too [25]. Verma et al conducted a study of PPCs in patients of emergency abdominal surgeries and found that pre-operative abnormal chest X-ray changes were 3 times more common in the PPCs group as compared to the control group without PPCs [26].…”

Ameliyat Sonrası Dönemde Solunum Egzersizi Günlüğü Kullanımının Düzenli Spirometre Kullanımına Etkisi: Randomize Kontrollü Çalışma

“…Ameliyat öncesi dönemde hastanın ameliyat ve sonrası dönem için iyi hazırlanması, ameliyat sonrası komplikasyonların önlenmesinde yardımcı olmaktadır [3][4][5] . Özellikle büyük cerrahi girişimlerin (toraks ve batın cerrahisi gibi) sonrasında solunum komplikasyonları %12.5-%54.5 arasında değişen oranlarda görülmekte olup, cerrahi insizyonun diyafragmaya yakın olması durumunda bu oranların arttığı bildirilmektedir [6][7][8][9] . Literatürde torasik ve abdominal cerrahide %42.4 10 , torasik cerrahide %6.2 11 , üst abdominal cerrahide %20 12 oranında solunum komplikasyonlarının görüldüğü bildirilmektedir.…”