Gebeyehu Geresu, Eshetu Ashenafi, Aweke Senait
Department of Anesthesia, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Anesthesia, College of Medicine and Health Sciences, DebreBirhan University, DebreBirhan, Ethiopia.
Anesthesiol Res Pract. 2022 Jul 6;2022:8223903. doi: 10.1155/2022/8223903. eCollection 2022.
Postoperative pulmonary complications are a wide variety of disorders that affect normal respiratory functions, which in turn lead to morbidity and mortality. The extent to which it occurs is not yet studied in most clinical settings. This study assessed the incidence and risk factors of postoperative pulmonary complications in patients undergoing abdominal surgery under general anesthesia.
A multicenter, prospective cross-sectional study was conducted at Menelik II, Tikur Anbessa Specialized, Zewditu Memorial, and Yekatit 12 Memorial hospitals after obtaining ethical clearance from each hospital. The study recruited a total of 287 participants using systematic random sampling. The data collection tool included sociodemographic, surgical, and anesthetic factors. Participants were followed for 7 days postoperatively, and any respiratory problems were recorded once identified. The collected data were entered and analyzed using SPSS version 26. Both bivariate and multivariate logistic regressions were used for analysis. A value of <0.05 was considered statistically significant.
About 33% of the participants that underwent abdominal surgery developed postoperative pulmonary complications. Age > 65 years (AOR = 12.091, 95% CI = 3.310-44.169), duration of surgery >3 hours (AOR = 11.737, 95% CI = 3.621-38.039), preoperative oxygen saturation <94% (AOR = 10.671, 95% CI = 3.794-30.016), and postoperative serum albumin level <3.5 g/dl ( value <0.001) were associated with postoperative pulmonary complications significantly. The incidence of postoperative pulmonary complications after abdominal surgeries was high. Age >65years, duration of surgery >3 hours, preoperative SpO2% <94%, cigarette smoking, and postoperative serum albumin level <3.5 g/dl were factors strongly associated with postoperative pulmonary complications. We recommend special care for elderly patients, limit the surgical duration to less than 3 hours, treat the underlying cause of desaturation, and correct postoperative serum albumin to prevent the occurrence of postoperative pulmonary complications.
术后肺部并发症是一系列影响正常呼吸功能的疾病，进而导致发病和死亡。在大多数临床环境中，其发生程度尚未得到研究。本研究评估了全身麻醉下接受腹部手术患者术后肺部并发症的发生率及危险因素。
在梅内利克二世医院、提库尔·安贝萨专科医院、泽韦迪图纪念医院和叶卡提特12纪念医院获得各医院伦理批准后，开展了一项多中心、前瞻性横断面研究。该研究采用系统随机抽样共招募了287名参与者。数据收集工具包括社会人口统计学、手术和麻醉因素。对参与者术后进行7天随访，一旦发现任何呼吸问题即进行记录。收集的数据使用SPSS 26版录入并分析。采用双变量和多变量逻辑回归进行分析。P值<0.05被认为具有统计学意义。
约33%接受腹部手术的参与者发生了术后肺部并发症。年龄>65岁（调整后比值比[AOR]=12.091，95%置信区间[CI]=3.310 - 44.169）、手术时间>3小时（AOR = 11.737，95% CI = 3.621 - 38.039）、术前血氧饱和度<94%（AOR = 10.671，95% CI = 3.794 - 30.016）以及术后血清白蛋白水平<3.5 g/dl（P值<0.001）与术后肺部并发症显著相关。腹部手术后术后肺部并发症的发生率较高。年龄>65岁、手术时间>3小时、术前动脉血氧饱和度（SpO2）%<94%、吸烟以及术后血清白蛋白水平<3.5 g/dl是与术后肺部并发症密切相关的因素。我们建议对老年患者给予特别护理，将手术时间限制在3小时以内，治疗血氧饱和度降低的潜在原因，并纠正术后血清白蛋白水平，以预防术后肺部并发症的发生。
