The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan.
Autor: | Abdel Jalil R; Department of Surgery, King Hussein Cancer Center, Amman, Jordan. DA.06648@KHCC.JO.; Thoracic Surgery Unit, Lung Service Tumor Board, Surgical Residency Program, King Hussein Cancer Center, Amman, 1194, Jordan. DA.06648@KHCC.JO., Al-Najjar H; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Abou Chaar MK; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Al-Masri M; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Daoud F; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Al-Ebous A; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Dabous A; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Shehadeh AM; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Abdel Al S; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Alawneh F; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Al-Qudah O; Department of Surgery, King Hussein Cancer Center, Amman, Jordan., Al-Kharabsheh M; Department of Nursing, King Hussein Cancer Center, Amman, Jordan., Al-Odat G; Department of Nursing, King Hussein Cancer Center, Amman, Jordan., Mohammad I; Department of Nursing, King Hussein Cancer Center, Amman, Jordan., Hussein N; Department of Nursing, King Hussein Cancer Center, Amman, Jordan., Hudaip Z; Department of Nursing, King Hussein Cancer Center, Amman, Jordan., Al-Tbakhi A; Respiratory Therapy Unit, King Hussein Cancer Center Amman, Amman, Jordan., Aqel F; Respiratory Therapy Unit, King Hussein Cancer Center Amman, Amman, Jordan. |
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Jazyk: | angličtina |
Zdroj: | Patient safety in surgery [Patient Saf Surg] 2021 Jan 06; Vol. 15 (1), pp. 5. Date of Electronic Publication: 2021 Jan 06. |
DOI: | 10.1186/s13037-020-00277-z |
Abstrakt: | Background: Postoperative pulmonary complications can be a major catastrophic consequence of major surgeries and can lead to increased morbidity, mortality, hospital stay, and cost. Many protocols have been tried to reduce serious adverse outcomes with effective strategies including a bundle of preoperative, intraoperative and postoperative techniques. Using these techniques maybe challenging in developing countries with limited resources even in specialized centers. Methods: A before-and-after trial comparing our data from the national surgical quality improvement program (NSQIP) based on their reports. Data was collected prospectively for the patients who underwent major surgeries at King Hussein Cancer Center during the year 2017 when the use of the perioperative pulmonary care bundle was mandatory to all surgery teams and compared it with the data collected retrospectively for the patients who underwent the same type of surgeries in the year 2016 when the use of such a bundle was optional. The primary end point is the decrease in incidence of postoperative pulmonary complications. Simple descriptive statistical analysis was used to obtain results. Results: The potential risk factors for postoperative pulmonary complications for 1665 patients divided into 2 groups (2016 vs. 2017); 764 (45.9%) vs. 901 (54.1%), respectively. There were no significant differences regarding gender (male 46.7% vs. 46.4%, P value = 0.891, female 53.3% vs. 53.6%, P value = 0.39), mean of age (53.5 year vs. 5.28 year, P value = 0.296), mean of body mass index (BMI) (28.6 vs. 6%, 28.6, P value = 0.95), smoking status; (69.6% vs. 65.1%, P value = 0.052), ventilator use (0.3% vs. 0.4% P value = 0.693) and chronic obstructive pulmonary disease (1.4% vs. 1.4 with, P value = 0.996).The data showed a significant reduction in postoperative pneumonia between the 2 groups (2016 vs. 2017) (2.7% vs. 0.9%, P value = 0.004) and showed a significant reduction in unplanned intubation, 1.4% in 2016 vs. 0.7% in 2017. Conclusions: The standardization of perioperative pulmonary care bundle, including smoking cessation, perioperative pulmonary interventions and early mobilization, significantly reduces the incidence of postoperative pulmonary complications in cancer patients. This technique's implementation was feasible easily even with limited resources in a developing country like Jordan. |
Databáze: | MEDLINE |
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