Kodra Nertila, Shpata Vjollca, Ohri Ilir
University Hospital Center "Mother Teresa", Tirana, Albania.
Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albania.
Open Access Maced J Med Sci. 2016 Jun 15;4(2):259-63. doi: 10.3889/oamjms.2016.059. Epub 2016 May 22.
Incidence of postoperative pulmonary complications (PPC) in patients undergoing non-cardiothoracic surgery remains high and the occurrence of these complications has enormous implications for the patient and the health care system.
The aim of the study was to identify risk factors for PPC in patients undergoing abdominal surgical procedures.
A prospective cohort study in abdominal surgical patients, admitted to the emergency and surgical ward of the UHC of Tirana, Albania, was conducted during the period: March 2014-March 2015. We collected data on the occurrence of a symptomatic and clinically significant PPC using clinical, laboratory, and radiology data. We evaluated the relations between PPCs and various pre-operative or intra-operative factors to identify risk factors.
A total of 450 postoperative patients admitted to the surgical emergency and surgical ward were studied. The mean age were 59.85 ±13.64 years with 59.3% being male. Incidence of PPC was 27.3% (123 patients) and hospital length of stay was 4.93 ± 4.65 days. Length of stay was substantially prolonged for those patients who developed PPC (7.48 ± 2.89 days versus 3.97± 4.83 days, p < 0.0001. PPC were identified as risk factors for mortality, OR: 21.84; 95% CI: 11.66-40.89; P < 0.0001. The multivariate regression analysis identified as being independently associated with an increased risk of PPC: age ≥ 65 years (OR 11.41; 95% CI: 4.84-26.91, p < 0.0001), duration of operation ≥ 2.5 hours (OR 8.38; 95% CI: 1.52-46.03, p = 0.01, history of previous pulmonary diseases (OR 11.12; 95% CI: 3.28-37.65, P = 0.0001) and ASA > 2 (OR 6.37; 95% CI: 1.54-26.36, P = 0.01).
We must do some efforts in reducing postoperative pulmonary complications, firstly to identify which patients are at increased risk, and then following more closely high-risk patients because those patients are most likely to benefit.
非心胸外科手术患者术后肺部并发症（PPC）的发生率仍然很高，这些并发症的发生对患者和医疗保健系统具有重大影响。
本研究的目的是确定接受腹部外科手术患者发生PPC的危险因素。
于2014年3月至2015年3月期间，在阿尔巴尼亚地拉那大学医院中心的急诊和外科病房对腹部外科手术患者进行了一项前瞻性队列研究。我们使用临床、实验室和放射学数据收集了有症状且具有临床意义的PPC发生情况的数据。我们评估了PPC与各种术前或术中因素之间的关系，以确定危险因素。
共研究了450名入住外科急诊和外科病房的术后患者。平均年龄为59.85±13.64岁，男性占59.3%。PPC的发生率为27.3%（123例患者），住院时间为4.93±4.65天。发生PPC的患者住院时间显著延长（7.48±2.89天对3.97±4.83天，p<0.0001）。PPC被确定为死亡的危险因素，OR：21.84；95%CI：11.66 - 40.89；P<0.0001。多因素回归分析确定与PPC风险增加独立相关的因素为：年龄≥65岁（OR 11.41；95%CI：4.84 - 26.91，p<0.0001）、手术时间≥2.5小时（OR 8.38；95%CI：1.52 - 46.03，p = 0.01）、既往肺部疾病史（OR 11.12；95%CI：3.28 - 37.65，P = 0.0001）和ASA>2（OR 6.37；95%CI：1.54 - 26.36，P = 0.01）。
我们必须在减少术后肺部并发症方面做出努力，首先要确定哪些患者风险增加，然后对高危患者进行更密切的随访，因为这些患者最有可能从中受益。
