Hospital de Clínicas de Porto Alegre, Serviço de Anestesia e Medicina Perioperatória, Porto Alegre, RS, Brazil.
Hospital de Clínicas de Porto Alegre, Serviço de Anestesia e Medicina Perioperatória, Porto Alegre, RS, Brazil.
Braz J Anesthesiol. 2021 Jul-Aug;71(4):333-338. doi: 10.1016/j.bjane.2021.02.003. Epub 2021 Feb 3.
Postoperative pulmonary complications are the main cause of morbidity and mortality after pulmonary resection. This study was undertaken to determine the risk factors associated with postoperative pulmonary complications (PPCs) and length of hospital stay (LOS) in pulmonary resection patients in a tertiary teaching hospital in Brazil.
A retrospective data gathering from 196 patients who underwent pulmonary resection between 2012 and 2016 was conducted. Demographic and hospital admission data were collected from patients with complete medical records. Univariate analysis was performed, followed by Poisson's regression for predicting the prevalence of postoperative pulmonary complications and length of hospital stay.
Thirty-nine patients (20%) displayed pulmonary complications in the postoperative period. The risk factors associated with an increased prevalence of postoperative pulmonary complications in a multivariate analysis were: American Society of Anesthesiologists physical status (ASA) ≥ 3 (PR 4.77, p = 0.03, 95% CI: 1.17 to 19.46), predicted diffusion capacity of the lungs for carbon monoxide - corrected single breath (PR 0.98, p < 0.001, 95% CI: 0.96 to 0.99) and age of the patient (PR 1.04; p = 0.01; 95% CI: 1.01 to 1.06). Those associated with an increased prevalence of prolonged hospital stay were: duration of surgical procedure longer than five hours (PR 6.94, p = 0.01, 95% CI: 1.66 to 12.23), male sex (PR 5.72, p < 0.001, 95% CI: 1.87 to 9.58), and presence of postoperative pulmonary complications (PR 11.92, p < 0.001, 95% CI: 7.42 to 16.42).
The rate of postoperative pulmonary complications in the study population is in line with the world average. Recognizing risk factors for the development of PPCs may help optimize allocation resources and preventive efforts.
术后肺部并发症是肺切除术后发病率和死亡率的主要原因。本研究旨在确定巴西一家三级教学医院肺切除术后患者发生术后肺部并发症（PPCs）和住院时间（LOS）的相关风险因素。
回顾性收集了 2012 年至 2016 年间 196 例接受肺切除术的患者数据。从有完整病历记录的患者中收集人口统计学和入院数据。进行单因素分析，然后使用泊松回归预测术后肺部并发症的发生率和住院时间。
39 例（20%）患者术后出现肺部并发症。多因素分析显示，与术后肺部并发症发生率增加相关的危险因素为：美国麻醉医师协会（ASA）身体状况≥3（PR 4.77，p = 0.03，95%CI：1.17 至 19.46）、预测一氧化碳单呼吸弥散能力校正值（PR 0.98，p < 0.001，95%CI：0.96 至 0.99）和患者年龄（PR 1.04；p = 0.01；95%CI：1.01 至 1.06）。与住院时间延长相关的因素包括：手术时间超过 5 小时（PR 6.94，p = 0.01，95%CI：1.66 至 12.23）、男性（PR 5.72，p < 0.001，95%CI：1.87 至 9.58）和术后肺部并发症（PR 11.92，p < 0.001，95%CI：7.42 至 16.42）。
研究人群的术后肺部并发症发生率与世界平均水平一致。认识 PPCs 发生的危险因素有助于优化资源配置和预防措施。
