Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery

V. Perilli, P. Aceto, P. Ancona, R. De Cicco, D. Papanice, S. Magalini, G. Pepe, V. Cozza, D. Gui, C. Lai, L. Sollazzi

Research output: Contribution to journalArticle

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Abstract

objective: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. patients and methods: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. results: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (X2 with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (X2with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. conclusions: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these results.

Original languageEnglish
Pages (from-to)547-550
Number of pages4
JournalEuropean Review for Medical and Pharmacological Sciences
Volume22
Issue number2
Publication statusPublished - Jan 1 2018

Fingerprint

Lung
Aspiration Pneumonia
Bronchial Spasm
Pulmonary Atelectasis
Pneumothorax
Pleural Effusion
Hospital Mortality
Intubation
Respiratory Insufficiency
Thorax
Retrospective Studies
Logistic Models
X-Rays
Prospective Studies
Sensitivity and Specificity
Infection

Keywords

  • Abdominal surgery
  • Elective
  • Laparoscopic
  • Open
  • Patients-centered care
  • Personalized risk profile
  • Postoperative pulmonary complications
  • Prediction
  • Surgical approach
  • Surgical setting
  • Urgent

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery. / Perilli, V.; Aceto, P.; Ancona, P.; De Cicco, R.; Papanice, D.; Magalini, S.; Pepe, G.; Cozza, V.; Gui, D.; Lai, C.; Sollazzi, L.

In: European Review for Medical and Pharmacological Sciences, Vol. 22, No. 2, 01.01.2018, p. 547-550.

Research output: Contribution to journalArticle

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abstract = "objective: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. patients and methods: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. results: PPCs prevalence was greater in urgent (33{\%}) vs. elective setting (7{\%}) (X2 with Yates correction: 44; p=0.0001) and in open (6{\%}) vs. laparoscopic approach (1.9{\%}) (X2with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94{\%} sensitivity and 29{\%} specificity. conclusions: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these results.",
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AU - Aceto, P.

AU - Ancona, P.

AU - De Cicco, R.

AU - Papanice, D.

AU - Magalini, S.

AU - Pepe, G.

AU - Cozza, V.

AU - Gui, D.

AU - Lai, C.

AU - Sollazzi, L.

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AB - objective: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. patients and methods: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. results: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (X2 with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (X2with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. conclusions: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these results.

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KW - Surgical approach

KW - Surgical setting

KW - Urgent

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