Risk Factors for Postoperative Pulmonary Complications After Noncardiothoracic Surgery in Adult Asthma Patients

Abstract

Background: Postoperative pulmonary complications (PPC) are common and important after noncardiothoracic surgery in the patients with chronic obstructive airway disease. Despite variable risk factors and preoperative management have been described for PPC, there are only a few studies that focused on asthma patients. The aim of the present study is to investigate the incidence and risk factors of PPC after noncardiothoracic surgery with adult asthma patients. Methods: The electronic medical records at the Pusan National University Yangsan Hospital (January 2009 to December 2012) were retrospectively reviewed to identify asthma patients who had evaluated preoperative risk associated with asthma by respiratory physician before noncardiothoracic surgery. Clinical characteristics, history of previous asthma management and the results of preoperative examination were analyzed for determine their association with the occurrence of PPC. Results: Total of one hundred and twentyseven patients was included and thirtyseven (29.1%) experienced PPC. Twelve patients (32.4%) had pneumonia, 9 (24.3%) bronchospasm, 7 (18.9%) atelectasis, 6 (16.2%) prolonged mechanical ventilation and 3 (8.1%) acute respiratory insufficiency. Risk factors for PPC were age, presence of respiratory symptoms and low FEV1. No significant difference between patients with or without PPC was found for gender, O2 saturation, abnormal chest radiologic imaging and preoperative systemic steroid administration. The development of PPC was associated with prolonged hospital stay (P < 0.05). Conclusion(s): The incidence of PPC after noncardiothoracic surgery with adult asthma patients was 29.1% and the most common PPC was pneumonia. Risk factors were age, presence of respiratory symptoms and low FEV1.