Abnormal preoperative pulmonary function tests were independently associated with a significantly higher risk of postoperative pulmonary complications (aOR 4.05; 95% CI 1.72–9.53; p<0.001).
Cohort (n=729)
Are abnormal preoperative pulmonary function tests associated with increased postoperative pulmonary complications in adults undergoing noncardiac surgery?
Abnormal preoperative pulmonary function tests, particularly reduced FEV1, are strongly associated with an increased risk of postoperative pulmonary complications in noncardiac surgery.
Effect estimate: aOR 4.05 (95% CI 1.72–9.53)
Absolute Event Rate: 29.7% vs 8.7%
p-value: p=<0.001
ABSTRACT Background Postoperative pulmonary complications (PPCs) increase surgical morbidity and mortality. While the predictive value of preoperative pulmonary function tests (PFTs) in noncardiac surgery remains unclear, we evaluated whether abnormal PFT patterns and spirometric indices are independently associated with PPCs. Methods We retrospectively analyzed adult patients undergoing noncardiac surgery under general or spinal anesthesia between June and November 2022 with preoperative spirometry. PFTs were classified as normal or abnormal using lower limit of normal criteria. PPCs within 7 postoperative days were defined using European Perioperative Clinical Outcome criteria. Associations were assessed using multivariable logistic regression before and after propensity score–based overlap weighting. Continuous spirometric indices were also analyzed. Results Among 729 patients, 64 (8.8%) had abnormal PFTs. PPCs were significantly more frequent in the abnormal PFTs group (29.7% vs. 8.7%; p < 0.001). After overlap weighting, abnormal PFTs remained independently associated with PPCs (adjusted odds ratio aOR 4.05, 95% CI 1.72–9.53; p < 0.001), along with open surgery (aOR 8.94, 95% CI 2.38–33.59; p = 0.001). Lower FEV 1 and %FEV 1 were consistently associated with increased PPC risk across all models, whereas associations with FVC and FEV 1 /FVC were inconsistent. Conclusions Abnormal preoperative PFTs and reduced FEV 1 are independently associated with PPCs after noncardiac surgery. Preoperative spirometry aids perioperative risk stratification, particularly for invasive surgery.
Cho et al. (Mon,) conducted a cohort in Noncardiac surgery (n=729). Abnormal preoperative pulmonary function tests (PFTs) vs. Normal PFTs was evaluated on Postoperative pulmonary complications (PPCs) within 7 postoperative days (aOR 4.05, 95% CI 1.72–9.53, p=<0.001). Abnormal preoperative pulmonary function tests were independently associated with a significantly higher risk of postoperative pulmonary complications (aOR 4.05; 95% CI 1.72–9.53; p<0.001).