Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Yoshimi, Kaku; Oh, Shiaki; Suzuki, Kenji; Kodama, Yuzo; Sekiya, Mitsuaki; Seyama, Kuniaki; Fukuchi, Yoshinosuke

doi:10.5761/atcs.oa.15-00301

Cited by 11 publications

(12 citation statements)

References 18 publications

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“…[ 15 , 16 ] Here our results revealed an incidence of respiratory failure of 18.7%, a higher incidence rate than numerous rates reported previously. [ 17 , 18 ] In a large multicenter observational study by Arozullah and colleagues, respiratory failure developed in 3.4% of patients who had undergone noncardiac operations followed by postsurgical administration of mechanical ventilation of duration exceeding 48 hours. [ 10 ] Therefore, variable incidence rates reported for postoperative respiratory failure reflect variability of definitions and procedures across studies.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with postoperative respiratory failure in tuberculous empyema patients

Ruan¹,

Liu

Gong³

et al. 2021

Medicine

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Our objective was to identify independent risk factors for predicting which patients in the Chinese population would likely develop respiratory failure. A descriptive analysis was conducted of demographic and clinical data of patients with tuberculous empyema (TE) admitted to the Beijing Chest Hospital, Capital Medical University between January 2001 and January 2020. Risk factors associated with postsurgical respiratory failure in TE patients were identified based on results of analyses based on univariable and multivariable logistic regression models. A total of 139 TE patients who underwent surgical treatment in the Beijing Chest Hospital, Capital Medical University from January 2001 to January 2020 were enrolled in this study. Cases included 109 male and 30 female patients, with an overall mean age (range 17–73) of 39.3 years. Of 139 TE patients, 26 (18.7%) experienced respiratory failure after surgery. Among significant risk factors for postsurgical respiratory failure, intraoperative blood loss volume greater than 1000 mL had the highest odds ratio value of 6.452. In addition, a pathologic preoperative pulmonary function test result showing a high partial pressure of carbon dioxide level was an independent risk factor for respiratory failure. Moreover, the presence of tuberculosis lesions in the contralateral lung was another significant risk factor for respiratory failure, as determined using multivariate analysis. Respiratory failure is a predominant complication experienced by TE patients undergoing surgery. High intraoperative blood loss, high preoperative high partial pressure of carbon dioxide level, and tuberculosis lesion(s) in the contralateral lung of TE patients were associated with increased risk of postoperative respiratory failure.

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Section: Discussionmentioning

confidence: 99%

Risk factors associated with postoperative respiratory failure in tuberculous empyema patients

Ruan¹,

Liu

Gong³

et al. 2021

Medicine

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“…Patients with abnormal results of PFT (especially low FEV1) are at a higher risk for PPCs. These patients should undergo adequate preoperative examinations to identify the surgical risks and appropriate measures that need to be taken to improve the patient's lung function and decrease the risk of PPCs (49)(50)(51)(52). Some patients may benefit from optimization of lung function by pulmonary physician.…”

Section: Preoperative Pulmonary Function Assessmentmentioning

confidence: 99%

Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery

Gao

Barello

Chen

et al. 2019

Transl Lung Cancer Res

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“…For such patients, physicians were generally reluctant to prescribe LAMA, which may cause adverse reactions such as ischuria, because contraindication for patients with prostate hypertrophy associated with urination disorder is provided in the package insert of LAMA. The median number of days between referral to the pulmonologist and surgery was 7.5 days (IQR, 3.25-20.75) in the bronchodilator group and 7 days (IQR, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] in the control group. No statistical difference was observed between the two groups (P = 0.20).…”

Section: Resultsmentioning

confidence: 99%

“…9,10 Furthermore, airflow limitation itself may confer risk for PPC. 11 Consequently, preoperative risk assessment by pulmonary function testing (PFT) is performed. Following such procedure, untreated patients with OLD are frequently incidentally discovered.…”

Section: Introductionmentioning

confidence: 99%

Preoperative intervention with long‐acting bronchodilators for the reduction of postoperative pulmonary complications in untreated patients with obstructive lung disease

Mikami

Matsuzaki

et al. 2019

Clinical Respiratory J

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Abbreviations: ACO, asthma and COPD overlap; ARISCAT, assess respiratory risk in surgical patients in Catalonia; BA, bronchial asthma; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; LAB, long-acting bronchodilators; OLD, obstructive lung diseases; PPC, postoperative pulmonary complications. AbstractBackground: Obstructive lung disease (OLD) is a risk factor for postoperative pulmonary complications (PPC) and is incidentally discovered during preoperative evaluation. The key treatments for OLD are inhaled long-acting bronchodilators (LAB). However, the advantage of preoperative bronchodilator treatment for patients with OLD remains unclear. The aim of this study is to elucidate the effect of preoperative LAB treatment in patients with untreated OLD on postoperative outcomes. Methods: In this propensity-matched cohort study, we included patients who were referred to the pulmonologists for untreated OLD. The patients were either treated with LAB or left untreated. The primary outcome was the incidence of prolonged oxygen therapy (>3 days) in the postoperative period. We evaluated patients' characteristics with and without the use of LAB using propensity score (PS) matching weight. Subsequently, the outcomes in the two groups were compared. Results: We analysed 614 patients; 132 patients were part of the LAB group and 482 were included in the control group. In the crude analysis, the incidence of prolonged oxygen therapy was higher in the LAB group than in the control group (odds ratio [OR] = 1.35; P = 0.04). However, after PS matching weight, no statistically significant differences in prolonged oxygen therapy (OR = 1.15), incidence of prolonged intensive care unit stay, endotracheal re-intubation postoperatively and in-hospital death between the groups were identified. Conclusion: There is a limited benefit of preoperative treatment with inhaled LAB for the reduction of PPC in patients with untreated OLD. K E Y W O R D Sbronchodilator agents, COPD, general anaesthesia, postoperative pulmonary complications | 93 MIKAMI et Al.

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Impact of Airflow Limitation on Comorbidities and Postoperative Complications in Patients Undergoing Thoracic Surgery: A Retrospective Observational Study

Cited by 11 publications

References 18 publications

Risk factors associated with postoperative respiratory failure in tuberculous empyema patients

Risk factors associated with postoperative respiratory failure in tuberculous empyema patients

Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery

Preoperative intervention with long‐acting bronchodilators for the reduction of postoperative pulmonary complications in untreated patients with obstructive lung disease

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