Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery.
OBJECTIVE
The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia.


METHODS
Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiary university hospital.


METHODS
We retrospectively studied 3107 patients over 11 years old presenting American Society of Anesthesiologists (ASA) status I, II or III who underwent upper abdominal surgery under general anesthesia and were discharged to the recovery room. The preoperative conditions analyzed using logistic regression were: age, sex, ASA physical status, congestive heart failure, asthma, chronic obstructive pulmonary disease (COPD), respiratory failure and smoking. The outcomes or dependent variables included intraoperative and postoperative events: bronchospasm, hypoxemia, hypercapnia, prolonged intubation and airway secretion.


RESULTS
Among these patients (1500 males, 1607 females, mean age 48 years, 1088 ASA I, 1402 ASA II and 617 ASA III), there were 80 congestive heart failures, 82 asthmatics, 122 with COPD, 21 respiratory failures and 428 smokers. Logistic regression analysis showed that female sex (p < 0.001), age over 70 years (p < 0.01), smoking (p < 0.001) and COPD (p < 0.02) significantly influenced pulmonary event development, particularly hypoxemia and bronchospasm, at both times but not in the same patients. Asthma and congestive heart failure cases did not present pulmonary events in the recovery room.


CONCLUSIONS
In upper abdominal surgery under general anesthesia, female sex, age over 70, smoking and COPD were independent risk factors for intra and postoperative pulmonary events.
Sakai
Rafael Luis
RL
Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
Abrão
Graciela Maria Gera
GM
Ayres
José Franscisco Vasques
JF
Vianna
Pedro Thadeu Galvão
PT
Carvalho
Lídia Raquel de
LR
Castiglia
Yara Marcondes Machado
YM
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018681:Anesthetics, General / Q000009:adverse effects*; D001249:Asthma / Q000150:complications; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
D018681:Anesthetics, General