Key result
Postoperative pulmonary complications occurred in 12.6% of patients undergoing elective major abdominal surgery and were associated with increased one-year mortality (OR 3.078, 95% CI 1.825-5.191).
Why the study?
Postoperative pulmonary complications contribute significantly to morbidity and mortality, but their incidence and association with early and 1-year mortality in patients without pre-existing respiratory disease needed evaluation.
What is the incidence of postoperative pulmonary complications and their association with mortality in patients without pre-existing respiratory disease undergoing elective major abdominal surgery?
Observational (n=1,542)
Yes
What is the incidence of postoperative pulmonary complications and their association with mortality in patients without pre-existing respiratory disease undergoing elective major abdominal surgery?
Postoperative pulmonary complications are common (12.6%) after major elective abdominal surgery in patients without pre-existing respiratory disease and are strongly associated with increased 1-year mortality.
Answers are grounded in this paper and cite their sources.
PPCs warrant heightened perioperative vigilance in abdominal surgery patients; leaves open whether prevention strategies improve one-year survival.
BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease. METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality. RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre- and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001). CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.
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Piccioni et al. (2023) conducted an observational in Elective major abdominal surgery (n=1,542). Elective major abdominal surgery was evaluated on Incidence of postoperative pulmonary complications (PPCs) (95% CI 11.1-14.4). Postoperative pulmonary complications occurred in 12.6% of patients undergoing elective major abdominal surgery and were associated with increased one-year mortality (OR 3.078, 95% CI 1.825-5.191).
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