Published ahead of print on November 24, 2004, doi:10.1164/rccm.200408-1069OC Am. J. Respir. Crit. Care Med., Volume 171, Number 5, March 2005, 514-517 A more recent version of this article appeared on March 1, 2005
Submitted on August 20, 2004 Incidence of and Risk Factors for Pulmonary Complications after Non-thoracic SurgeryFinlay A McAlister1*,1 Division of General Internal Medicine, University of Alberta, Edmonton, Alberta, Canada, 2 Department of Anesthesiology and Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada * To whom correspondence should be addressed. E-mail: Finlay.McAlister{at}ualberta.ca.
The prediction of post-operative pulmonary complications is an under-investigated field. We conducted a prospective cohort study (with postoperative pulmonary complications ascertained by an investigator blinded to perioperative variables) to determine the risk factors for pulmonary complications after elective non-thoracic surgery. Of 1055 consecutive patients attending the Pre-Admission Clinic of a university hospital (mean age 55 years, 50% men, 15% with history of obstructive airways disease), 28 (2.7%) suffered a postoperative pulmonary complication within 7 days of surgery: 13 patients developed respiratory failure requiring ventilatory support, 9 pneumonia, 5 atelectasis requiring bronchoscopic intervention, and 1 pneumothorax requiring intervention. Mean lengths of stay were substantially prolonged for those patients who developed pulmonary complications within 7 days of surgery: 27.9 days versus 4.5 days, p=0.006. Eight variables were statistically significantly associated with pulmonary complications on bivariate analyses. Multivariate analyses revealed that 4 were independently associated with increased risk of pulmonary complications: age (OR 5.9 for age Key words: complications, postoperative clinical skills pulmonary function tests
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65 years, p<0.001), positive cough test (OR 3.8, p=0.01), perioperative nasogastric tube (OR 7.7, p<0.001), and duration of anesthesia (OR 3.3 for operations lasting at least 2.5 hours, p=0.008). Thus, several perioperative factors predict an increased risk for pulmonary complications after elective non-thoracic surgery.
