Evaluation of Postoperative Pulmonary Complications after Emergency Abdominal Surgery- A Prospective Study

Abstract

Introduction: The clinical outcomes following the emergency abdominal surgery besides the surgical complications and the complications due to co-morbidities are influenced by Postoperative Pulmonary Complications (PPC). Continuous health care improvements are directed towards delivering quality care for postoperative patients is the need of the hour in prevailing patient-centric health services in the society. Aim: To evaluate the outcomes after emergency abdominal surgery in relation to pulmonary complications. Materials and Methods: A prospective observational study was conducted in the Department of Pulmonary Medicine and General Surgery at Peoples College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India for a period of one year. Thirty five patients who were operated for emergency abdominal surgery were included in the study. A predesigned and validated proforma was used for the collection of data. In the postoperative period, continuous clinical monitoring and evaluation was done periodically. The primary outcome was PPC like atelectasis, pneumonia, pleural effusion, pulmonary edema, acute respiratory failure. The European Perioperative Clinical Outcome (EPCO) definitions were used for the primary outcome. Descriptive statistics were used for data analysis. The association of pre and postoperative data with the occurrence of PPC was analysed using the Z-test for two sample proportions. The p-value <0.05 was taken as statistically significant. Results: In the study group of 35 patients, 18 patients (51.4%) developed PPC as defined by the selected criteria. Nine (25.7%) patients had pneumonia, 4 (11.4%) patients had acute respiratory failure, 2 (5.7%) patients had pleural effusion, 2 (5.7%) patients had pulmonary edema and 1 (2.9%) patient had atelectasis. The habit of smoking (p=0.003), presence of pre-existing underlying lung disease (p=0.004), and low socioeconomic status (p=0.012) were associated with increased risk for PPC in patients undergoing emergency abdominal surgery with statistically significant results. Conclusion: Pulmonary complications after emergency abdominal surgery are common and leads to the morbidity of patients and may result in fatal outcomes.