Source: Haematologica  |  Posted 6 years ago

By Ed Susman

MONTREAL, CANADA -- November 7, 2005 -- The risk of a patient suffering pulmonary complications after abdominal surgery appears to have fallen dramatically at a community hospital in Brooklyn, New York, United States.

The researchers suggest that the decline in complications might be due to an increase in laparoscopy procedures conducted at that institution.

"Postoperative pulmonary complications occurred among 9 out of 200 consecutive patients who underwent abdominal surgery," said Fayez Bader, MD, resident in pulmonary medicine, Long Island College Hospital, Brooklyn, New York, United States.

"There were no complications in patients undergoing laparoscopy," Dr. Bader said November 2[^]nd[] in a poster presentation here at the American College of Chest Physicians Annual Meeting (CHEST).

His study is an interim report of data gleaned from a retrospective study. Data from 200 consecutive patients undergoing abdominal surgery in 2004 were collected via electronic files of medical records at the community hospital.

The researchers defined postoperative pulmonary complications as 2 or more conditions occurring on 2 consecutive days within a week of surgery. Those conditions were:

- New cough with sputum production;
- Physical findings consistent with segmental or greater atelectasis or pneumonia; temperature above 38 decrees C;
- Segmental or greater atelectasis or new infiltrate on radiographs.

Additionally, exacerbation of preexisting lung disease, respiratory failure, and pulmonary embolism were included as postoperative pulmonary complications.

Dr. Bader said that use of nasogastric tubes was heavily associated with pulmonary complications after abdominal surgery. All the complications occurred among patients with nasogastric tubes. Among patients without complications, about 18% had nasogastric tubes.

The risk of having lung complications after surgery was 40 times greater in patients who had surgery that required placement of the nasogastric tube, Dr. Bader said.

"The frequency of, and risk factors for postoperation pulmonary complications after abdominal surgery are incompletely understood," he said.

"While there were fewer complications," Dr. Bader said, "those patients with complications did impact health care resources."

Length of stay was statistically greater in patients with complications -- 14.9 days in patients having postoperative problems versus 5.5 days for patients without complications, a difference that reached statistical significance at the P < .001 level, Dr. Bayer said.

He said the data leads him to speculate that the low incidence of complications -- about 4.5% -- may be due to a more clinically relevant definition of the condition, improved technology, and the increased use of less invasive surgical strategies such as laparoscopy.

[Presentation title: Postoperative Pulmonary Complications After Abdominal Surgery.]