title: Preoperative spirometry and perioperative drug therapy in patients with obstructive pulmonary dysfunction.
abstract: OBJECTIVE
  The presence and severity of obstructive pulmonary diseases is important determinants of non-fatal and fatal postoperative complications. This study examined the characteristics of patients in need of perioperative drug therapy for obstructive pulmonary dysfunction.
  
  
  METHODS
  Among 2,358 surgical patients who, between September 2009 and February 2010, underwent spirometry at the Tokai University Hospital, the 333 whose forced expiratory volume in 1 second (FEV1) / forced vital capacity ratio was <0.7 were studied retrospectively. Single and multiple variable logistic regression analyses were performed in search of predictors of need for drug therapy.
  
  
  RESULTS
  Among the 230 men and 103 women (mean age = 68 ± 11 years) with obstructive pulmonary dysfunction, 108 (32%) received perioperative drug therapy with bronchodilators, inhaled corticosteroids or both. By multiple variable analysis, perioperative drug therapy was significantly correlated with a history of asthma and ever smoking, cough or sputum production, FEV1 <50% predicted, and emphysema, independently of consultations with pulmonologists. In a decision tree analysis, FEV1 and smoking history were the independent predictors of perioperative drug therapy.
  
  
  CONCLUSIONS
  Composite assessment of clinical history, respiratory symptoms, and pulmonary function is necessary for the efficient screening of the subjects who require perioperative drug therapy for obstructive pulmonary dysfunction.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Takiguchi
authors.forename: Kyoko
authors.initials: K
authors.lastname: Niimi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomomatsu
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tomomatsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Hayama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.forename: Takuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Urano
authors.forename: Satomi
authors.initials: S
authors.lastname: Asai
authors.forename: Hayato
authors.initials: H
authors.lastname: Miyachi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Abe
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. ko-asano@tokai-u.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D001249:Asthma; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016015:Logistic Models; D008173:Lung Diseases, Obstructive / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D057234:Preoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012907:Smoking; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents