Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery

CONTEXT AND OBJECTIVE: The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. DESIGN AND SETTING: Retrospective study for which data were obtained pr...

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Main Authors: Rafael Luis Sakai, Graciela Maria Gera Abrão, José Franscisco Vasques Ayres, Pedro Thadeu Galvão Vianna, Lídia Raquel de Carvalho, Yara Marcondes Machado Castiglia
Format: Article
Language:English
Published: Associação Paulista de Medicina
Series:São Paulo Medical Journal
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600003&lng=en&tlng=en
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spelling doaj-69349c32e40c41f7bba67bbe3f8c15e22020-11-25T01:44:54ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460125631532110.1590/S1516-31802007000600003S1516-31802007000600003Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgeryRafael Luis Sakai0Graciela Maria Gera Abrão1José Franscisco Vasques Ayres2Pedro Thadeu Galvão Vianna3Lídia Raquel de Carvalho4Yara Marcondes Machado Castiglia5Universidade Estadual PaulistaUniversidade Estadual PaulistaUniversidade Estadual PaulistaUniversidade Estadual PaulistaUniversidade Estadual PaulistaUniversidade Estadual PaulistaCONTEXT AND OBJECTIVE: The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. DESIGN AND SETTING: Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiary university hospital. METHODS: We retrospectively studied 3107 patients over 11 years old presenting American Society of Anesthesiologists (ASA) status I, II or III who underwent upper abdominal surgery under general anesthesia and were discharged to the recovery room. The preoperative conditions analyzed using logistic regression were: age, sex, ASA physical status, congestive heart failure, asthma, chronic obstructive pulmonary disease (COPD), respiratory failure and smoking. The outcomes or dependent variables included intraoperative and postoperative events: bronchospasm, hypoxemia, hypercapnia, prolonged intubation and airway secretion. RESULTS: Among these patients (1500 males, 1607 females, mean age 48 years, 1088 ASA I, 1402 ASA II and 617 ASA III), there were 80 congestive heart failures, 82 asthmatics, 122 with COPD, 21 respiratory failures and 428 smokers. Logistic regression analysis showed that female sex (p < 0.001), age over 70 years (p < 0.01), smoking (p < 0.001) and COPD (p < 0.02) significantly influenced pulmonary event development, particularly hypoxemia and bronchospasm, at both times but not in the same patients. Asthma and congestive heart failure cases did not present pulmonary events in the recovery room. CONCLUSION: In upper abdominal surgery under general anesthesia, female sex, age over 70, smoking and COPD were independent risk factors for intra and postoperative pulmonary events.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600003&lng=en&tlng=enGeneral anesthesiaGastrointestinal surgical proceduresChronic obstructive pulmonary diseaseRecovery roomRespiratory insufficiency
collection DOAJ
language English
format Article
sources DOAJ
author Rafael Luis Sakai
Graciela Maria Gera Abrão
José Franscisco Vasques Ayres
Pedro Thadeu Galvão Vianna
Lídia Raquel de Carvalho
Yara Marcondes Machado Castiglia
spellingShingle Rafael Luis Sakai
Graciela Maria Gera Abrão
José Franscisco Vasques Ayres
Pedro Thadeu Galvão Vianna
Lídia Raquel de Carvalho
Yara Marcondes Machado Castiglia
Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
São Paulo Medical Journal
General anesthesia
Gastrointestinal surgical procedures
Chronic obstructive pulmonary disease
Recovery room
Respiratory insufficiency
author_facet Rafael Luis Sakai
Graciela Maria Gera Abrão
José Franscisco Vasques Ayres
Pedro Thadeu Galvão Vianna
Lídia Raquel de Carvalho
Yara Marcondes Machado Castiglia
author_sort Rafael Luis Sakai
title Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
title_short Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
title_full Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
title_fullStr Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
title_full_unstemmed Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
title_sort prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery
publisher Associação Paulista de Medicina
series São Paulo Medical Journal
issn 1806-9460
description CONTEXT AND OBJECTIVE: The significant relationship between upper abdominal surgery and early (perioperative) pulmonary events was investigated among patients with preoperative pulmonary conditions undergoing general anesthesia. DESIGN AND SETTING: Retrospective study for which data were obtained prospectively from 1999 to 2004, at a tertiary university hospital. METHODS: We retrospectively studied 3107 patients over 11 years old presenting American Society of Anesthesiologists (ASA) status I, II or III who underwent upper abdominal surgery under general anesthesia and were discharged to the recovery room. The preoperative conditions analyzed using logistic regression were: age, sex, ASA physical status, congestive heart failure, asthma, chronic obstructive pulmonary disease (COPD), respiratory failure and smoking. The outcomes or dependent variables included intraoperative and postoperative events: bronchospasm, hypoxemia, hypercapnia, prolonged intubation and airway secretion. RESULTS: Among these patients (1500 males, 1607 females, mean age 48 years, 1088 ASA I, 1402 ASA II and 617 ASA III), there were 80 congestive heart failures, 82 asthmatics, 122 with COPD, 21 respiratory failures and 428 smokers. Logistic regression analysis showed that female sex (p < 0.001), age over 70 years (p < 0.01), smoking (p < 0.001) and COPD (p < 0.02) significantly influenced pulmonary event development, particularly hypoxemia and bronchospasm, at both times but not in the same patients. Asthma and congestive heart failure cases did not present pulmonary events in the recovery room. CONCLUSION: In upper abdominal surgery under general anesthesia, female sex, age over 70, smoking and COPD were independent risk factors for intra and postoperative pulmonary events.
topic General anesthesia
Gastrointestinal surgical procedures
Chronic obstructive pulmonary disease
Recovery room
Respiratory insufficiency
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600003&lng=en&tlng=en
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