Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

Kodra, Nertila; Shpata, Vjollca; Ohri, I.

doi:10.3889/oamjms.2016.059

Cited by 31 publications

(24 citation statements)

References 20 publications

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“…The risk factors for development of PPCs from our study were found to be incision type, presence of comorbidities, duration of surgery, length of critical care stay, and hospital stay. These findings were also reported in other studies which looked at predictors of PPCs in patients (Rudra and Das 2006 ; Jensen and Yang 2007 ; Denu et al 2015 , Kodra, Shpata and Ohri 2016 ). Gender, age over 65 years and category of surgery were not found to be associated with development of PPCs in our study contrary to other studies (Jensen and Yang 2007 , Denu et al, 2015 , Kodra, Shpata and Ohri 2016 ).…”

Section: Discussionsupporting

confidence: 85%

“…Studies conducted in low-income countries showed that 10–15% of hospital admissions were due to diseases amenable to surgical treatment, of which diseases were more prevalent in the young population compared to high income countries (Hanekom, Coetzee and Faure 2006 , Frankel et al, 2007 , Semer, Sullivan and Meara 2010 , Chalya et al, 2011 , Pearse et al, 2012 , Kodra, Shpata and Ohri 2016 ) and the same pattern was noted in the current study. The affected age group in African countries of between 15 and 44 years is the predominant economically active segment of the population.…”

Section: Discussionmentioning

confidence: 99%

“…To reduce the incidence or prevalence of PPCs, there must be an understanding of patient conditions that increase the risk of developing PPCs and of effective interventions available to reduce the impact of pre-existing patient’s conditions on the subsequent development of PPCs (Rudra and Das 2006 , Denu et al, 2015 , Kodra, Shpata and Ohri 2016 ). The risk factors for development of PPCs from our study were found to be incision type, presence of comorbidities, duration of surgery, length of critical care stay, and hospital stay.…”

Section: Discussionmentioning

confidence: 99%

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The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study

et al. 2017

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BackgroundThe burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge. The objective of the study was to determine the pulmonary complications developing after abdominal and thoracic surgery and the associated risks factors.MethodsA retrospective records review of all abdominal and thoracic surgery patients admitted at a central hospital from January 2014 to October 2014 was done. Data collected included demographic data, surgical history, comorbidities and the PPCs present.ResultsOut of the 92 patients whose records were reviewed, 55 (59.8%) were males and 84 (91.3%) had abdominal surgery. The mean age of the patients was 42.6 years (SD = 18.4). The common comorbidities were HIV infection noted in 14(15.2%) of the patients and hypertension in 10 (13.0%). Thirty nine (42.4%) developed PPCs and the most common complications were nosocomial pneumonia in 21 (22.8%) patients, ventilator associated pneumonia in 11 (12.0%), and atelectasis in 6 (6.5%) patients. Logistic regression showed that a history of alcohol consumption, prolonged surgery, prolonged stay in hospital or critical care unit, incision type, and comorbidities were significant risk factors for PPCs (p < 0.05). The mortality rate was 10.9%.ConclusionPPCs like nosocomial and ventilator associated pneumonia were common and were associated with increased morbidity and adversely affected clinical outcomes of patients. HIV and hypertension presented significant comorbidities which the health team needed to recognize and address. Strategies to reduce the occurrence of PPCs have to be implemented through coordinated efforts by the health practitioners as a team during the entire perioperative period.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study

et al. 2017

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“…The time a patient remains anesthetized is directly related to the frequency of complications; hypothermia, deep venous thrombosis, pulmonary thromboembolism, changes in coagulation, bleeding, alterations in the immune system, and neurovascular compressions are some of the usual drawbacks in prolonged surgery-anesthesia [26]. In plastic surgery, there are procedures that require prolonged times such as patients with combined surgeries and postbariatric cases with large weight loss.…”

Section: Surgery Timementioning

confidence: 99%

Perioperative Complications in Plastic Surgery

Whizar-Lugo¹,

Campos-León²,

AlejandroMoreno-Guillen³

2019

Anesthesia Topics for Plastic and Reconstructive Surgery

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Anesthetic complications in the perioperative period in plastic surgery are extremely rare, although they can be catastrophic and sometimes fatal. The proper selection and correct preoperative assessment of patients are the key to stay away from unwanted events. Preanesthesia evaluation is mandatory in each patient and must include clinical history, complete physical examination, and routine and special laboratory tests in patients with associated pathologies. Anesthetic management is based on these results, type of surgery, experience of the anesthesiologist, and the operating environment. The anesthetic technique can be local, regional, or general with standard noninvasive monitoring. It is recommended that an anesthesiologist be present in all plastic surgery procedures. Complications are usually the result of moving away from the guidelines already established for an excellent practice or the result of sentinel events rather than human errors. Pulmonary embolism is probably the most feared complication, with soft tissue infections being the most frequent complication in plastic surgery. Less common complications include arrhythmias, overhydration, allergies, bleeding, skin necrosis, dehiscence of wounds, brain damage, and dead. Anesthesiologists, surgeons, nurses, and all personnel involved in the care of these patients must work as a team of highly qualified and updated professionals.

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“…The estimated incidence of PPCs varies greatly, ranging from as low as 5% to as high as 70%, depending on the type of surgery, which PPCs are included in the estimate and the study population [2]. PPCs are particularly common among patients who have undergone cardiac [3], thoracic [4] or upper abdominal surgery [5], and the patient's underlying pulmonary status and comorbidities are just a few of the many factors which contribute to the individual's risk of PPC after surgery [2].…”

Section: Introductionmentioning

confidence: 99%

A Real-World Evidence Study Assessing the Impact of Adding the Aerobika Oscillating Positive Expiratory Pressure Device to Standard of Care Upon Healthcare Resource Utilization and Costs in Post-Operative Patients

et al. 2018

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Introduction The aim of this real-world study was to measure the benefit of the Aerobika oscillating positive expiratory pressure (OPEP) device when added to standard of care (defined as incentive spirometry [IS]) for post-operative patients. Methods Adults aged ≥ 18 years who were hospitalized for cardiac, thoracic or upper abdominal surgery between 1 September 2013 and 30 April 2017 were identified from IQVIA’s Hospital Charge Detail Master (CDM) database; the index date was the date of the first hospitalization for surgery. The control cohort (IS) included patients who had ≥ 1 CDM record within 12 months prior to the index date and ≥ 1 record after discharge, evidence of IS use during index hospitalization and no evidence of use of a PEP or OPEP device at any time during the study period. The Aerobika OPEP cohort was selected in a similar manner, except that patients were required to have evidence of Aerobika OPEP use during the index hospitalization. Aerobika OPEP patients were 1:1 matched to IS patients using propensity score (PS) matching. Hospital readmissions and costs were measured at 30 days post-discharge from the index hospitalization. Results After PS matching, 144 patients were included in each cohort. At 30 days post-discharge, compared to the control (IS) cohort there were significantly fewer patients in the Aerobika OPEP cohort with ≥ 1 all-cause re-hospitalizations (13.9 vs. 22.9%; p = 0.042). The patients in the Aerobika OPEP cohort also had a shorter mean length of stay (± standard deviation) (1.25 ± 4.04 vs. 2.60 ± 8.24 days; p = 0.047) and lower total unadjusted mean all-cause cost per patient ($3670 ± $13,894 vs. $13,775 ± $84,238; p = 0.057). Adjusted analyses suggested that hospitalization costs were 80% lower for the Aerobika OPEP cohort versus the IS cohort (p = 0.001). Conclusion Our results suggest that the addition of the Aerobika OPEP device to standard of care (IS) is beneficial in the post-operative setting. Funding Trudell Medical International.

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Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

Cited by 31 publications

References 20 publications

The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study

The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study

Perioperative Complications in Plastic Surgery

A Real-World Evidence Study Assessing the Impact of Adding the Aerobika Oscillating Positive Expiratory Pressure Device to Standard of Care Upon Healthcare Resource Utilization and Costs in Post-Operative Patients

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