Lower respiratory tract infections after abdominal operations: epidemiology and risk factors.

OBJECTIVE

To find out the incidence and aetiology of lower respiratory tract infections after abdominal operations and identify predisposing factors.

DESIGN

Prospective open study.

SETTING

Department of General Surgery, Hospital Germans Trias i Pujol, Barcelona, Spain.

SUBJECTS

2,083 patients having abdominal operations between March 1985 and June 1987 excluding splenectomies, and those requiring thoracoabdominal incisions.

MAIN OUTCOME MEASURES

The presence of three or more of the following: temperature of 38 degrees C or more, cough with mucopurulent sputum, raised white cell count, or changes on the chest radiograph or bronchogram.

RESULTS

50 patients (2.4%) developed lower respiratory tract infections. Micro-organisms were isolated from 15 (30%), the most common being Haemophilus influenzae. The most important risk factors were American Society of Anesthesiologist's grade, duration of anaesthesia, age, and operations on the upper gastrointestinal tract.

CONCLUSION

Further work is needed to investigate other possible predisposing factors and develop a predictive score.