Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery

The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiar...

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Bibliographic Details
Published in:	São Paulo medical journal Vol. 125; no. 6; pp. 315 - 321
Main Authors:	Sakai, Rafael Luis, Abrão, Graciela Maria Gera, Ayres, José Franscisco Vasques, Vianna, Pedro Thadeu Galvão, Carvalho, Lídia Raquel de, Castiglia, Yara Marcondes Machado
Format:	Journal Article
Language:	English
Published:	Brazil Associação Paulista de Medicina - APM 01-11-2007 Associação Paulista de Medicina
Subjects:	Abdomen - surgery Adolescent Adult Age Factors Aged Aged, 80 and over Anesthetics, General - adverse effects Asthma - complications Child Chronic obstructive pulmonary disease Epidemiologic Methods Female Gastrointestinal surgical procedures General anesthesia Humans Intraoperative Complications - etiology Lung - drug effects Lung - pathology Male MEDICINE, GENERAL & INTERNAL Middle Aged Original Postoperative Complications - etiology Prognosis Pulmonary Disease, Chronic Obstructive - complications Recovery room Respiratory insufficiency Respiratory Insufficiency - complications Sex Factors Smoking - adverse effects Young Adult Doença pulmonar obstrutiva crônica Respiratory insufficiency Recovery room Procedimentos cirúrgicos do sistema digestório Insuficiência respiratória Anestesia geral General anesthesia Chronic obstructive pulmonary disease Sala de recuperação Gastrointestinal surgical procedures
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Summary:	The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiary university hospital. 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. 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. 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.
Bibliography:	Conflicts of interest: None
ISSN:	1516-3180 1806-9460 1516-3180 1806-9460
DOI:	10.1590/s1516-31802007000600003