Accuracy of the preoperative assessment in predicting pulmonary risk after nonthoracic surgery

Finlay A. McAlister, Nadia A. Khan, Sharon E. Straus, Miltiadis Papaioakim, Bruce W. Fisher, Sumit R. Majumdar, Ognjen Gajic, Malcolm Daniel, George Tomlinson

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

We examined the accuracy of preoperative assessment in predicting postoperative pulmonary risk in a prospective cohort of 272 consecutive patients referred for evaluation before nonthoracic surgery. Outcomes were assessed by an independent investigator who was blinded to the preoperative data. There were 22 (8%) postoperative pulmonary complications. Statistically significant predictors of pulmonary complications (all p ≤ 0.005) were as follows: hypercapnea of 45 mm Hg or more (odds ratio, 61.0), a FVC of less than 1.5 L/minute (odds ratio, 11.1), a maximal laryngeal height of 4 cm or less (odds ratio, 6.9), a forced expiratory time of 9 seconds or more (odds ratio, 5.7), smoking of 40 pack-years or more (odds ratio, 5.7), and a body mass index of 30 or more (odds ratio, 4.1). Multiple regression analyses revealed three preoperative clinical factors that are independently associated with pulmonary complications: an age of 65 years or more (odds ratio, 1.8; p = 0.02), smoking of 40 pack-years or more (odds ratio, 1.9; p = 0.02), and maximum laryngeal height of 4 cm or less (odds ratio, 2.0; p = 0.007). Thus, preoperative factors can identify those patients referred to pulmonologists or internists who are at increased risk for pulmonary complications after nonthoracic surgery.

Original languageEnglish (US)
Pages (from-to)741-744
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Volume167
Issue number5
DOIs
StatePublished - Mar 1 2003

Keywords

  • Clinical skills
  • Complications
  • Postoperative
  • Pulmonary function tests

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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  • Cite this

    McAlister, F. A., Khan, N. A., Straus, S. E., Papaioakim, M., Fisher, B. W., Majumdar, S. R., Gajic, O., Daniel, M., & Tomlinson, G. (2003). Accuracy of the preoperative assessment in predicting pulmonary risk after nonthoracic surgery. American journal of respiratory and critical care medicine, 167(5), 741-744. https://doi.org/10.1164/rccm.200209-985BC