title: Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery.
abstract: 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.
authors.affiliation: Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: Rafael Luis
authors.initials: RL
authors.lastname: Sakai
authors.forename: Graciela Maria Gera
authors.initials: GM
authors.lastname: Abrão
authors.forename: José Franscisco Vasques
authors.initials: JF
authors.lastname: Ayres
authors.forename: Pedro Thadeu Galvão
authors.initials: PT
authors.lastname: Vianna
authors.forename: Lídia Raquel de
authors.initials: LR
authors.lastname: Carvalho
authors.forename: Yara Marcondes Machado
authors.initials: YM
authors.lastname: Castiglia
mesh_terms: 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
chemical_list: D018681:Anesthetics, General