Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patientsopen access
- Authors
- Shin, Beomsu; Lee, Hyun; Kang, Danbee; Jeong, Byeong-Ho; Kang, Hyung Koo; Chon, Hae Ri; Koh, Won-Jung; Chung, Man Pyo; Guallar, Eliseo; Cho, Juhee; Park, Hye Yun
- Issue Date
- Jul-2017
- Publisher
- WILEY-BLACKWELL
- Keywords
- chronic obstructive pulmonary disease; complications; spirometry; surgery
- Citation
- RESPIROLOGY, v.22, no.5, pp.935 - 941
- Indexed
- SCIE
SCOPUS
- Journal Title
- RESPIROLOGY
- Volume
- 22
- Number
- 5
- Start Page
- 935
- End Page
- 941
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/3510
- DOI
- 10.1111/resp.12988
- ISSN
- 1323-7799
- Abstract
- Background and objective
The association between airflow limitation severity and post-operative pulmonary complications (PPCs) among COPD patients undergoing extra-pulmonary surgery is unknown. We evaluated the association between forced expiratory volume in 1s (FEV1 ) and PPC in COPD patients undergoing extra-pulmonary surgery.
Methods
Using prospective cohort of PPC evaluation for extra-pulmonary surgery, we identified 694 COPD patients who conducted PPC evaluation before extra-pulmonary surgery between March 2014 and January 2015 at a tertiary hospital, Seoul, Korea.
Results
The overall incidence of PPC was 24.4%. The incidence of PPC in quintiles 1-5 of FEV1 (% predicted) was 31.4, 25.8, 23.7, 21.6 and 19.7%, respectively (P for trend: 0.019). In fully adjusted multivariable models, the relative risks (RRs, 95% CI) for PPC comparing participants in quintiles 1-4 of FEV1 (% predicted) with those in quintile 5 were 1.69 (1.03-2.79), 1.41 (0.83-2.37), 1.26 (0.75-2.11) and 1.30 (0.76-2.22), respectively (P for trend: 0.046). The association of severe airflow limitation with respiratory failure and post-operative exacerbations was stronger in participants who did not use bronchodilators compared with those who did.
Conclusion
We found a progressive and significant relationship between severity of airflow limitation and the incidence of PPC in COPD patients undergoing extra-pulmonary surgery. Furthermore, perioperative bronchodilator use was associated with a reduced risk of respiratory failure and post-operative exacerbations in patients with severe airflow limitation.
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