Preexisting COPD in patients undergoing emergency abdominal surgery was associated with an increased risk of postoperative pulmonary complications (OR 2.49) and ventilator dependence (OR 2.26), but not in-hospital mortality (OR 1.16).
Case-Control (n=402)
No
Does preexisting COPD increase the risk of postoperative morbidity and in-hospital mortality in patients undergoing emergency abdominal surgery?
Preexisting COPD in patients undergoing emergency abdominal surgery is associated with an increased risk of postoperative pulmonary complications and ventilator dependence, but not in-hospital mortality.
Odds Ratio: 1.16 (95% CI 0.7–1.97)
Absolute Event Rate: 41.3% vs 30.8%
p-value: p=0.591
PURPOSE: The current study was undertaken to describe the independent contribution of chronic obstructive pulmonary disease (COPD) to the risk of postoperative morbidity and in-hospital mortality among patients undergoing surgery for an acute abdominal diagnosis. METHODS: Patients who underwent emergency abdominal procedures were identified from the electronic database of the Department of Visceral, Transplantation, Thoracic and Vascular Surgery of our institution. To evaluate differences in surgical risk associated with COPD, patients with COPD were matched for age, sex, and type of surgery with an equal number of controls who did not have COPD. Logistic regression was performed to evaluate the univariate and multivariate associations between the independent variables, including COPD and outcome variables. RESULTS: Between January 2012 and December 2022, 3519 patients undergoing abdominal emergency surgery were identified in our abdominal surgical department. After removing ineligible cases, 201 COPD cases with an equal number of matched controls remained for analysis. The prevalence of COPD after the exclusion of ineligible cases was 5.7%. There were statistically significant differences in the rate of postoperative pulmonary complications (PPCs 57.7% vs. 35.8%; P < 0.001), ventilator dependence (VD 63.2% vs. 46.3%; P < 0.001), thromboembolic events (TEEs 22.9% vs. 12.9%; P = 0.009), and in-hospital mortality (41.3% vs. 30.8%; P = 029) for patients with and without COPD. Independent of other covariates, the presence of COPD was not associated with a significantly increased risk of in-hospital mortality (OR, 1.16; 95% CI 0.70-1.97; P = 0.591) but was associated with an increased risk of PPCs (OR, 2.49; 95% CI 1.41-4.14; P = 0.002) and VD (OR, 2.26; 95% CI 1.22-4.17; P = 0.009). CONCLUSIONS: Preexisting COPD may alter a patient's risk of PPCs and VD. However, it was not associated with an increased risk of in-hospital mortality.
Kassahun et al. (2023) conducted a case-control in Acute abdominal diagnosis requiring emergency surgery (n=402). Chronic obstructive pulmonary disease (COPD) vs. No COPD (matched controls) was evaluated on In-hospital mortality (OR 1.16, 95% CI 0.70-1.97, p=0.591). Preexisting COPD in patients undergoing emergency abdominal surgery was associated with an increased risk of postoperative pulmonary complications (OR 2.49) and ventilator dependence (OR 2.26), but not in-hospital mortality (OR 1.16).
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