Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery.
OBJECTIVE
To investigate associations between preoperative variables and postoperative pulmonary complications (PPC) in elective upper abdominal surgery.


METHODS
Prospective clinical trial.


METHODS
A tertiary university hospital.


METHODS
408 patients were prospectively analyzed during the preoperative period and followed up postoperatively for pulmonary complications.


METHODS
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.
Pereira
E D
ED
Pulmonary Division, Universidade Federal de São Paulo, Brazil.
Fernandes
A L
AL
da Silva Anção
M
M
de Araúja Pereres
C
C
Atallah
A N
AN
Faresin
S M
SM
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D013147:Spirometry