Abstract
Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria. This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined. The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p< 0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05). The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and FVC were associated with PPCs.
Highlights
Pre-operative assessment in all forms of surgery is important, complex, and multi-disciplinary, and is designedAfrican Health SciencesAfrican Health Sciences Vol 19 Issue 1, March, 2019 respiratory failure, exacerbation of underlying chronic lung disease and respiratory distress syndrome.[8,9,10] The prevalence of pulmonary complications (PPCs) varies widely (5-80%), and is influenced by patients’ population and defining criteria
Pre-operative cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and forced vital capacity (FVC) were associated with PPCs
This study showed that pre-operative cough, shortness of breath, pneumonic consolidation, low percentage predicted FEV1 and low percentage predicted FVC were common in PPCs in patients undergoing elective abdominal surgery
Summary
Pre-operative assessment in all forms of surgery is important, complex, and multi-disciplinary, and is designed. PPCs occur in 25-50% of major surgeries.[11] The complications are patient- or procedure-related. The study subjects consisted of 50 patients >18 years, consecutively recruited from those booked for major elective abdominal surgeries during this period. Each performed forced expiratory manoeuvers, from total lung capacity to residual volume, to obtain measurements for peak expiratory force (PEF), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Univariate linear regression analysis was used to determine the strength of the pre-operative variables to predict the PPCs. All tests were two-tailed. Cough is defined as a common reflex action that clears the throat of mucus or foreign irritants
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