Postoperative pulmonary complications in noncardiothoracic surgery

Abstract

Purpose: Postoperative pulmonary complications (PPCs) are a major cause of mortality and morbidity. Theaim of this study is to evaluate frequencies and determine risk factors of PPCs which developed subsequent togeneral surgery and orthopedic surgery in a tertiary university hospital.Materials-methods: Patients who were operated in Departments of General Surgery and Orthopedics andTraumatology were retrospectively included to the study.Results: 683 patients with a mean age of 59.43±18.77 years were included in the study. The ratio of PPC was10.3%. Most frequent PPC was found to be pneumonia (6.3%). The prevelance of PPC was significantly higherin patients ≥65 years than who were <65 years old (18.2% vs 4.4%) (p<0.001). PPC was more frequent inpatients who undergone urgent surgery than those who undergone elective surgery (24.1% vs 8%) (p<0.001).The rates of development of PPC according to the duration of operation (30 min-1 h, 1-2 h, 2-3 h, 3-4 h, >4h) were respectively as follows 2.8%, 9.5%, 25%, 75% and 100% (p<0.001). Multivariable logistic regressionanalysis showed that being ≥65 years, having ASA≥3 and hypoalbuminemia (<3g/dl) were independent riskfactors for development of PPC (OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05;OR:6.4, 95% CI (3.14-13.1) p<0.05).Conclusion: The clinicians should be aware of PPCs especially in patients who were ≥65 years, had ASA≥3and hypoalbuminemia (<3g/dl).

Özet

Abstract Purpose:Postoperative pulmonary complications (PPCs) are a majör cause of mortality and morbidity.Aim of the study to evaluate frequencies and determine risk factors of PPCs which developed subsequent to general surgery and orthopedic surgery in a tertiary university hospital. Materials- Methods:Patients who were operated in Departments of General Surgery and Orthopedics and Traumatology were retrospectively included to the study. Results: 683 patients with a mean age of 59.43 ± 18.77 years were included in the study. The ratio of PPC was 10.3%. Most frequent PPC was found to be pneumonia ( 6.3%).The prevelance of PPC was significantly higher in patients ≥ 65 years than who were <65 years old (18.2% vs 4.4%) (p<0.001). PPC was more frequent in patients who undergone urgent surgery than those who undergone elective surgery (24.1% vs 8%) (p<0.001).The rates of development of PPC according to the duration of opera-tion (30 min-1 h, 1-2 h, 2-3 h, 3-4 h, >4 h ) were respectively as follows 2.8%, 9.5%, 25%, 75% and 100% (p<0.001). Multivariable logistic regression analysis showed that being ≥ 65 years, having ASA≥3 and hypoalbuminemia (<3g/dl) were independent risk factors for development of PPC [OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05; OR:6.4, 95% CI (3.14-13.1) p<0.05]. Conclusion: The clinicians should be aware of PPCs especially in patients who were ≥ 65 years, had ASA≥3 and hypoalbuminemia (<3g/dl). Kardiyotorasik dışı cerrahilerde postoperatif pulmoner komplikasyonlar Özet Amaç:Postoperatif pulmoner komplikasyonlar (PPK) önemli mortalite ve morbidite sebebidir. Çalışmamızın amacı ortopedi ve genel cerrahi operasyonlarından sonra gelişen PPK sıklığını ve risk faktörlerini belirlemektir. Gereç ve Yöntem:Genel cerrahi, ortopedi ve travmatoloji kliniklerinde opere edilen haslar retrospektif olarak değerlendirildi. Bulgular: Ortalama yaşı 59.43±18.77 yıl olan 683 hasta çalışmaya alındı.PPK %10.3 idi. Pnömöni (%6.3) en sık görülen PPK olarak tespit edildi.PPK sıklığı 65 yaş ve üs-tünde altında göre belirgin olarak yüksek saptandı. (18.2% vs 4.4%) (p<0.001).Acil cerrahi operasyonlarda elektif operasyonlara göre daha sık tespit edildi (24.1% vs 8%) (p<0.001).Operasyon süresinine göre (30 dk-1 st,1-2 st,2-3 st,4 st, >4st) PPK gelişim oranı sırasıyla %2.8,%9.5,%25,%75 ve %100 olarak bulundu (p<0.001). Çok değiş-kenli logiistik regresyon analizine göre ASA≥3, hipoalbunemi (<3g/dl) ve 65 yaş üstü PPK gelişiminde bağımsız risk faktörü olarak saptandı [OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05; OR:6.4, 95% CI (3.14-13.1) p<0.05]. Sonuç:ASA≥3, hipoalbunemi (<3g/dl) ve 65 yaş üzerinde klinisyenler PPK açısından dikkatli olmalıdır.