| 제목 | Restrictive Spirometric Pattern and Postoperative Pulmonary Complications Following Non-cardiothoracic Surgery. | ||
|---|---|---|---|
| 작성자 | 관리자 | 등록일 | 2019-12-13 |
내용
Sci Rep. 2019 Sep 4;9(1):12750. doi: 10.1038/s41598-019-49158-1.
Restrictive Spirometric Pattern and Postoperative Pulmonary Complications Following Non-cardiothoracic Surgery.
Shin SH1, Shin B2, Kang D3, Cho J3,4,5, Kang HK6, Chon HR7, Kim JS8, Park HY1, Lee H9.
Author information
- 1
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- 2
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
- 3
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- 4
- Department of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
- 5
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
- 6
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Gyeonggi, South Korea.
- 7
- Department of Pulmonary Medicine, Osan Hankook Hospital, Osan, Gyeonggi, South Korea.
- 8
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inha University College of Medicine, Incheon, South Korea.
- 9
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea. namuhanayeyo@naver.com.
Abstract
Despite a substantial population of patients with a restrictive spirometric pattern, few studies have evaluated postoperative pulmonary complications (PPCs) after non-cardiothoracic surgery in these patients. We conducted a retrospective cohort study of 681 adults with a normal or restrictive spirometric pattern who were referred for preoperative evaluation of PPC risk before non-cardiothoracic surgery between March 2014 and January 2015. Overall, 8.7% (59/681) of study participants developed a PPC following non-cardiothoracic surgery. The occurrence of PPCs in patients with a restrictive spirometric pattern was higher than that in those with normal spirometry (12.4% [35/282] vs. 6.0% [24/399], P = 0.003). The occurrence of PPCs increased across the categories of restrictive spirometric pattern severity (6.0% with a normal spirometric pattern vs. 6.5% with a mild restrictive spirometric pattern [60 ≤ forced vital capacity (FVC) < 80% predicted] vs. 21.2% with a moderate-to-severe restrictive spirometric pattern [FVC < 60% predicted], P for trend test < 0.001). The length of hospital stay (P for trend = 0.002) was longer, and all-cause mortality at 30 days (P for trend = 0.008) and 90 days (P for trend = 0.001) was higher across the restrictive spirometric pattern severity. In multivariable-adjusted analyses, a moderate-to-severe restrictive spirometric pattern was associated with a higher risk of PPCs compared with a normal spirometric pattern (adjusted odds ratio 2.64, 95% confidence interval 1.22-5.67). The incidence of PPCs in patients with a restrictive spirometric pattern was higher than that in those with a normal spirometric pattern, especially in patients with a moderate-to-severe restrictive spirometric pattern. Patients with a moderate-to-severe restrictive spirometric pattern should be regarded as high risk for developing PPCs following non-cardiothoracic surgery.
