Risk factors of postoperative pulmonary complications in patients with asthma and COPD

Autor: Takanori Numata, Katsutoshi Nakayama, Satoko Fujii, Yoko Yumino, Nayuta Saito, Masahiro Yoshida, Yusuke Kurita, Kenji Kobayashi, Saburo Ito, Hirofumi Utsumi, Haruhiko Yanagisawa, Mitsuo Hashimoto, Hiroshi Wakui, Shunsuke Minagawa, Takeo Ishikawa, Hiromichi Hara, Jun Araya, Yumi Kaneko, Kazuyoshi Kuwano
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: BMC Pulmonary Medicine, Vol 18, Iss 1, Pp 1-8 (2018)
Druh dokumentu: article
ISSN: 1471-2466
DOI: 10.1186/s12890-017-0570-8
Popis: Abstract Background Postoperative pulmonary complications (PPC) in patients with pulmonary diseases remain to be resolved clinical issue. However, most evidence regarding PPC has been established more than 10 years ago. Therefore, it is necessary to evaluate perioperative management using new inhalant drugs in patients with obstructive pulmonary diseases. Methods April 2014 through March 2015, 346 adult patients with pulmonary diseases (257 asthma, 89 chronic obstructive pulmonary disease (COPD)) underwent non-pulmonary surgery except cataract surgery in our university hospital. To analyze the risk factors for PPC, we retrospectively evaluated physiological backgrounds, surgical factors and perioperative specific treatment for asthma and COPD. Results Finally, 29 patients with pulmonary diseases (22 asthma, 7 COPD) had PPC. In patients with asthma, smoking index (≥ 20 pack-years), peripheral blood eosinophil count (≥ 200/mm3) and severity (Global INitiative for Asthma(GINA) STEP ≥ 3) were significantly associated with PPC in the multivariate logistic regression analysis [odds ratio (95% confidence interval) = 5.4(1.4–20.8), 0.31 (0.11–0.84) and 3.2 (1.04–9.9), respectively]. In patients with COPD, age, introducing treatment for COPD, upper abdominal surgery and operation time (≥ 5 h) were significantly associated with PPC [1.18 (1.00–1.40), 0.09 (0.01–0.81), 21.2 (1.3–349) and 9.5 (1.2–77.4), respectively]. Conclusions History of smoking or severe asthma is a risk factor of PPC in patients with asthma, and age, upper abdominal surgery, or long operation time is a risk factor of PPC in patients with COPD. Adequate inhaled corticosteroids treatment in patients with eosinophilic asthma and introducing treatment for COPD in patients with COPD could reduce PPCs.
Databáze: Directory of Open Access Journals