scholarly journals Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery

1999 ◽  
Vol 117 (4) ◽  
pp. 151-160 ◽  
Author(s):  
Eanes Delgado Barros Pereira ◽  
Ana Luisa Godoy Fernandes ◽  
Meide da Silva Anção ◽  
Clóvis de Araújo Peres ◽  
Álvaro Nagib Atallah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Surgery ◽  
Pulmonary Disease ◽  
Pulmonary Complications ◽  
Smoking Habits ◽  
Chronic Pulmonary Disease ◽  
Postoperative Pulmonary Complications ◽  
Upper Abdominal Surgery ◽  
Duration Of Surgery ◽  
Upper Abdominal

OBJECTIVE: To investigate associations between preoperative variables and postoperative pulmonary complications (PPC) in elective upper abdominal surgery. DESIGN: Prospective clinical trial. SETTING: A tertiary university hospital. PATIENTS: 408 patients were prospectively analyzed during the preoperative period and followed up postoperatively for pulmonary complications. MEASUREMENTS: Patient characteristics, with clinical and physical evaluation, related diseases, smoking habits, and duration of surgery. Preoperative pulmonary function tests (PFT) were performed on 247 patients. RESULTS: The postoperative pulmonary complication rate was 14 percent. The significant predictors in univariate analyses of postoperative pulmonary complications were: age >50, smoking habits, presence of chronic pulmonary disease or respiratory symptoms at the time of evaluation, duration of surgery >210 minutes and comorbidity (p <0.04). In a logistic regression analysis, the statistically significant predictors were: presence of chronic pulmonary disease, surgery lasting >210 and comorbidity (p <0.009). CONCLUSIONS: There were three major clinical risk factors for pulmonary complications following upper abdominal surgery: chronic pulmonary disease, comorbidity, and surgery lasting more than 210 minutes. Those patients with three risk factors were three times more likely to develop a PPC compared to patients without any of these risk factors (p <0.001). PFT is indicated when there are uncertainties regarding the patient’s pulmonary status.

scholarly journals Do ARISCAT scores help to predict the incidence of postoperative pulmonary complications in elderly patients after upper abdominal surgery? An observational study at a single university hospital

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jitsupa Nithiuthai ◽  
Arunotai Siriussawakul ◽  
Rangsinee Junkai ◽  
Nutthakorn Horugsa ◽  
Sunit Jarungjitaree ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Assessment Tool ◽  
Area Under The Curve ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Surgical Patients ◽  
Postoperative Pulmonary Complications ◽  
Duration Of Surgery ◽  
Upper Abdominal

Abstract Background The incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence and risk factors of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais. Methods A retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores. Results In all, 1100 elderly postoperative patients were analyzed. Their mean age was 73.6 years, and 48.5% were male. Nearly half of their operations were laparoscopic cholecystectomies. The incidence of PPCs was 7.7%, with the most common being pleural effusion, atelectasis, and pneumonia. The factors associated with PPCs were preoperative oxygen saturation less than 96% (OR = 2.6, 1.2–5.5), albumin level below 3.5 g/dL (OR = 1.7, 1.0–2.8), duration of surgery exceeding 3 h (OR = 2.0, 1.0–4.2), and emergency surgery (OR = 2.8, 1.4–5.8). There was a relationship between ARISCAT score and PPC incidence, with a correlation coefficient of 0.226 (P < 0.001). The area under the curve was 0.72 (95% CI, 0.665–0.774; P < 0.001). Conclusions PPCs are common in elderly patients. They are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of Thai patients into PPC risk groups. The ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.

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