Preoperative Pulmonary Function Tests in COPD Patients Posted For Major Upper Abdominal Surgeries: Evaluation of Postoperative Pulmonary Complications
Preoperative Pulmonary Function Tests in COPD Patients Posted For Major Surgeries
Keywords:
Chronic pulmonary obstructive disease, pulmonary function test, post operative outcomeAbstract
Background & aims: Pulmonary complications are a major cause of morbidity and mortality during the post-operative period after major upper abdominal surgeries. The incidence of post-operative pulmonary complications has been reported to vary between 5% and 80%. Incidences vary between hospitals. Various factors affect postoperative pulmonary outcome. So our aim was to study various possible factors (Gender, age, PFT finding, type of anaesthesia) which have impact on post operative pulmonary outcome. Method: This retrospective study was conducted at our hospital to evaluate the incidence of postoperative pulmonary complications (PPC) in patients with chronic obstructive pulmonary disease (COPD) and altered pulmonary function tests that underwent elective major upper abdominal surgery. Incidences of PPC were studied in relation to gender, age, type of anaesthesia, smoking and PFT findings. In our study, 45 adult COPD patients with altered PFT (FEV1/FVC< 88% of predicted for women and < 89% of predicted for men) were included whose entire post-operative period until discharge was observed from record. Result: Among them, 20% of patients were experienced PPC in form of bronchospasm (8.88%), prolonged intubation and mechanical ventilation (4.44%), pneumonia (4.44%), acute respiratory insufficiency (2.22%). Risk factors for PPC were male gender, elderly (>65years), low FEV1/FVC (71.9 +10.9%), general anaesthesia. No significant differences were found for co-morbidity (COPD) and abnormal lung function test between patients with or without PPC. In our study none of patients was having severe respiratory symptoms before operation. Surgical duration for all patients was less than 180 minutes. Patients with PPC had longer hospital stays (16.6 +15.0 vs. 7.5 + 5.7 days) and stayed longer in surgical intensive care units (7.0 + 5.9 vs. 1.7 + 0.7 days) than did those with no complications (p < 0.05). Conclusion: The incidence of PPC was not statistically significant in COPD patients with altered PFTs who were undergone elective major upper abdominal surgeries. [Ushma S NJIRM 2017; 8(3):26-29]
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