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Perioperative Medicine
Published in: Perioperative Medicine 1/2016

Open Access 01-12-2016 | Research

Postoperative pulmonary complications following major elective abdominal surgery: a cohort study

Authors: Kamlesh Patel, Fatemeh Hadian, Aysha Ali, Graham Broadley, Kate Evans, Claire Horder, Marianne Johnstone, Fiona Langlands, Jake Matthews, Prithish Narayan, Priya Rallon, Charlotte Roberts, Sonali Shah, Ravinder Vohra

Published in: Perioperative Medicine | Issue 1/2016

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Abstract

Background

Postoperative pulmonary complications (PPC) are an under-reported but major cause of perioperative morbidity and mortality. The aim of this prospective, contemporary, multicentre cohort study of unselected patients undergoing major elective abdominal surgery was to determine the incidence and effects of PPC.

Methods

Data on all major elective abdominal operations performed over a 2-week period in December 2014 were collected in six hospitals. The primary outcome measure of PPC at 7 days was used. Univariate and multivariate analyses were performed to investigate how different factors were associated with PPC and the effects of such complications.

Results

Two hundred sixty-eight major elective abdominal operations were performed, and the internal validation showed that the data set was 99 % accurate. Thirty-two (11.9 %) PPC were reported at 7 days. PPC was more common in patients with a history of chronic obstructive pulmonary disease compared to those with no history (26.7 vs. 10.2 %, p < 0.001). PPC was not associated with other patient factors (e.g. age, gender, body mass index or other comorbidities), type/method of operation or postoperative analgesia. The risk of PPC appeared to increase with every additional minute of operating time independent of other factors (odds ratio 1.01 (95 % confidence intervals 1.00–1.02), p = 0.007). PPC significantly increase the length of hospital stay (10 vs. 3 days). Attendance to the emergency department within 30 days (27.3 vs. 10.6 %), 30-day readmission (21.7 vs. 9.9 %) and 30-day mortality (12.5 vs. 0.0 %) was higher in those with PPC.

Conclusions

PPC are common and have profound effects on outcomes. Strategies need to be considered to reduce PPC.
Appendix
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Metadata
Title
Postoperative pulmonary complications following major elective abdominal surgery: a cohort study
Authors
Kamlesh Patel
Fatemeh Hadian
Aysha Ali
Graham Broadley
Kate Evans
Claire Horder
Marianne Johnstone
Fiona Langlands
Jake Matthews
Prithish Narayan
Priya Rallon
Charlotte Roberts
Sonali Shah
Ravinder Vohra
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Perioperative Medicine / Issue 1/2016
Electronic ISSN: 2047-0525
DOI
https://doi.org/10.1186/s13741-016-0037-0

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