Incidence and risk factors for postoperative pulmonary complications in elective intracranial surgery.
OBJECTIVE
It has been shown that craniotomy may lead to a decrease in lung volumes and arterial blood gas tensions as well as a change in the respiratory pattern. The purpose of this study was to determine the incidence of postoperative pulmonary complications (PPCs) and the mortality rate in patients who have undergone elective craniotomy and to evaluate the associations between preoperative and postoperative variables and PPCs in this population.


METHODS
Two hundred thirty-six patients were followed up based on a protocol including a clinical questionnaire, physical examination and observation of clinical characteristics in the preoperative period, type of surgery performed, duration of surgery, time spent in the intensive care unit (ICU) and hospital, and the occurrence of any PPCs.


RESULTS
Postoperative pulmonary complications occurred in 58 patients (24.6%) and 23 other patients (10%) died. Predicting factors for PPCs according to multivariate analyses were as follows: type of surgery performed (p < 0.0001), prolonged mechanical ventilation >or= 48 hours (p < 0.0001), time spent in the ICU > 3 days (p < 0.0001), decrease in level of consciousness (p < 0.002), duration of surgery >or= 300 minutes (p < 0.01), and previous chronic lung disease (p < 0.04).


CONCLUSIONS
The incidence from March 2003 to March 2005 of PPCs in patients who had undergone craniotomy was 25% and death occurred in 10%. Some risk factors for PPCs may be predicted such as the type of surgery performed, prolonged mechanical ventilation, a longer time in the ICU, a decreased level of consciousness, duration of surgery, and previous chronic lung disease.
Sogame
Luciana Carrupt Machado
LC
Department of Applied Physiotherapy, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Universidade Federal de São Paulo, Brazil.
Vidotto
Milena Carlos
MC
Jardim
José Roberto
JR
Faresin
Sonia Maria
SM
D000328:Adult; D001927:Brain Diseases / Q000401:mortality* / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate