Risk Factors for Postoperative Pulmonary Complications in Upper Abdominal Surgery

Kanat, Fikret; Golcuk, Ayse; Teke, Turgut; Gölcük, Murat

doi:10.1111/j.1445-2197.2006.03993.x

Cited by 67 publications

(53 citation statements)

References 43 publications

(89 reference statements)

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“…Accordingly, in this study postoperative pneumonia was the most common postoperative pulmonary complication (85.2%). This is consistent with study conducted by Kanat et al [24], Gerard et al [27] and Brooks [26] where pneumonia was the leading postoperative pulmonary complication in their study. But it was higher comparable to study conducted by Toori et al, Modell et al and Medeiros [21][22][23] which was 16%, 45% and 37.2% respectively.…”

Section: Discussionsupporting

confidence: 83%

“…This rate is higher than the reported rates by Toori et al and Finlay et al [20,21] which was 8% and 5% respectively. However, compared to Medeiros et al, Fisher et al and Kanat et al [22][23][24] (PPC rates of 33.9%, 37% and 58.3% respectively), our reported rate of PPC was quite less. The above mentioned statistics clearly depict a wide range of PPC incidence because of difference in patient population and criteria used to define the PPC in different populations [9,25].…”

Section: Discussioncontrasting

confidence: 49%

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Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Denu¹,

Yasin²,

Melekie³

et al. 2015

J Anesth Clin Res

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Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 49%

Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Denu¹,

Yasin²,

Melekie³

et al. 2015

J Anesth Clin Res

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“…79,80,89 The risk of postoperative complications also depends on the type of surgery. The rate of complication is higher in patients undergoing abdominal surgery [90][91][92] and is also increased with aortic aneurysm repair, [93][94][95][96] vascular, 74,78,79,93 thoracic, 83,90,93,96 and neck surgery. 83,96,97 Gupta et al have shown an increased risk of postoperative complications (39% vs 18%), higher rate of transfer to ICU (24% vs 9%), and increased length of hospital stay in patients with obstructive sleep apnea compared with control subjects matched for age, sex, and body mass index (BMI).…”

Section: Evidence On Sleep Apnea As a Risk Factor For Perioperative Cmentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Vasu

Grewal

Doghramji

2012

Journal of Clinical Sleep Medicine

217

147

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Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management. OSAS has been shown to be associated with various healthrelated consequences, including increased rate of motor vehicle accidents, hypertension, diabetes mellitus, congestive heart failure, stroke, and all-cause mortality. [1][2][3][4][5][6][7][8][9] Recently, numerous studies have demonstrated that surgical patients with sleep apnea are at increased risk of having perioperative complications, including hypoxemia, pneumonia, diffi cult intubation, myocardial infarction, pulmonary embolism, atelectasis, cardiac arrhythmias, and unanticipated admission to the ICU. The majority of patients with OSA are undiagnosed upon admission and are at risk during the perioperative period, presumably due to their underlying sleep apnea. Therefore, it is very important to identify these patients preoperatively so that one can initiate appropriate perioperative measures. EpidemiologyOSAS is an extremely common sleep related breathing disorder, and its prevalence has been increasing throughout the world because of obesity and increasing age of the general population. Its prevalence is between 2% and 25% in the general population, depending upon how sleep apnea is defi ned. In an epidemiological study, Young et al. noted that the prevalence of sleep apnea, defi ned as apnea-hypopnea index (AHI) ≥ 5/h was 9% for women and 24% for men. 10 However, the prevalence of OSAS (defi ned as AHI ≥ 5/h and daytime sleepiness) was 2% in women and 4% in men. 10 The National Sleep Foundation (NSF) Sleep in America 2005Poll found that 1 in 4 Americans are at high risk of having sleep apnea based on the Berlin Questionnaire. 11 The prevalence of sleep apnea is much higher in surgical patients and depends on the type of surgery. In the bariatric surgery population, the prevalence of sleep apnea has been found to be > 70%. 12,13 It is the standard of care for these patients to get a formal sleep evaluation prior to undergoing the bariatric surgery. Howev...

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“…Furthermore, patients with altered levels of consciousness, neurological disorders, history of pulmonary disease, older age and gastroesophageal reflux disease are at risk of aspiration pneumonia [4,5]. The 30° elevation of the upper body has been shown to reduce the risk of aspiration pneumonia in the intensive care unit (ICU) [6].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia

Studer

Räber

Ott

et al. 2016

International Journal of Surgery

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2 Highlights-Postoperative aspiration pneumonia is a rare complication, however, remains a severe disease with a significant mortality of 27% in this series.-Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia.-The identification of those patients at increased risk for death after aspiration may help to further improve patients outcome. Conclusion: Postoperative aspiration pneumonia remains a severe complication with significant mortality. Increasing age, the need for intraoperative blood component transfusion and bilateral pulmonary infiltrates are independent risk factors for fatal outcome after aspiration pneumonia. Therefore, these patients suffering aspiration pneumonia require special attention and increased monitoring.

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Risk Factors for Postoperative Pulmonary Complications in Upper Abdominal Surgery

Cited by 67 publications

References 43 publications

Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Postoperative Pulmonary Complications and Associated Factors among Surgical Patients

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia

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