Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.003
Brazilian Journal of Anesthesiology
Clinical Research

Risk factors for postoperative pulmonary complications and prolonged hospital stay in pulmonary resection patients: a retrospective study

Clovis T. Bevilacqua Filho, André P. Schmidt, Elaine A. Felix, Fabiana Bianchi, Fernanda M. Guerra, Cristiano F. Andrade

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Abstract

Background
Postoperative pulmonary complications are the main cause of morbidity and mortality after pulmonary resection. This study was undertaken to determine the risk factors associated with postoperative pulmonary complications (PPCs) and length of hospital stay (LOS) in pulmonary resection patients in a tertiary teaching hospital in Brazil.

Methods
A retrospective data gathering from 196 patients who underwent pulmonary resection between 2012 and 2016 was conducted. Demographic and hospital admission data were collected from patients with complete medical records. Univariate analysis was performed, followed by Poisson’s regression for predicting the prevalence of postoperative pulmonary complications and length of hospital stay.

Results
Thirty-nine patients (20%) displayed pulmonary complications in the postoperative period. The risk factors associated with an increased prevalence of postoperative pulmonary complications in a multivariate analysis were: American Society of Anesthesiologists Physical Score ≥ 3 (PR 4.77, p = 0.03, 95% CI: 1.17 to 19.46), predicted diffusion capacity of the lungs for carbon monoxide – corrected single breath (PR 0.98, p < 0.001, 95% CI: 0.96 to 0.99) and age of the patient (PR 1.04; p = 0.01; 95% CI: 1.01 to 1.06). Those associated with an increased prevalence of prolonged hospital stay were: duration of surgical procedure longer than five hours (PR 6.94, p = 0.01, 95% CI 1.66 to 12.23), male sex (PR 5.72, p < 0.001, 95% CI 1.87 to 9.58), and presence of postoperative pulmonary complications (PR 11.92, p < 0.001, 95% CI 7.42 to 16.42).

Conclusions
The rate of postoperative pulmonary complications in the study population is in line with the world average. Recognizing risk factors for the development of PPCs may help optimize allocation resources and preventive efforts.

Keywords

Pleural effusion Pneumonia;  Pneumothorax;  Acute respiratory distress syndrome;  Pulmonary atelectasis;  Thoracotomy;  Ventilator-induced lung injury
6036c4eca95395572435f523 rba Articles
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Braz J Anesthesiol

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