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

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

Perioper Med (Lond)

West Midlands Research Collaborative, Academic Department of Surgery, School of Cancer Sciences, University of Birmingham, Birmingham, B15 2TH UK ; Nottingham Oesophago-Gastric Unit, Nottingham University Hospitals, Nottingham, UK.

Published: May 2016

AI Article Synopsis

Article Abstract

Background: Postoperative 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.

Methods: Data 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.

Results: Two 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.

Conclusions: PPC are common and have profound effects on outcomes. Strategies need to be considered to reduce PPC.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877761PMC
http://dx.doi.org/10.1186/s13741-016-0037-0DOI Listing

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