Airway obstruction and perioperative complications in smokers undergoing abdominal surgery

David Oman Warner, Mark A. Warner, Kenneth P. Offord, Darrell R. Schroeder, Pamela Maxson, Paul D Scanlon

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Background: The goal of this study was to determine whether airway obstruction determined by preoperative spirometry predicts perioperative complications in smokers undergoing abdominal surgery whose treatment is managed according to current clinical practice. Methods: A pulmonary function database identified patients undergoing abdominal surgery who met the following criteria for airway obstruction (n = 135): a forced expiratory volume less than 40% of predicted normal value, a forced expiratory volume:forced vital capacity ratio less than the lower limit of predicted normal, a smoking history of more than 20 pack-years, and an age older than 35 yr. A group of patients without airway obstruction (n = 135) was matched for gender, surgical site (upper vs. lower abdominal), smoking history, and age. Medical records were reviewed by an abstractor to identify perioperative complications that occurred within 30 days after surgery. Results: The forced expiratory volume values were 0.9 ± 0.2 l (mean ± SD) and 2.9 ± 0.6 l in patients with and without airway obstruction, respectively. When analyzed by conditional logistic regression using the 1:1 matched-pairs feature, including age, pack-year smoking history, site of incision, and current smoking status as covariates, in patients with airway obstruction bronchospasm was more likely to develop (odds ratio, 6.9 [95% confidence interval, 1.2 to 38.4]) but the patients were not more likely to need prolonged endotracheal intubation (odds ratio, 1.11 [95% confidence interval, 0.4 to 3.2]). They were also no more likely to need prolonged intensive care admission or readmission. The frequency of other complications was less than 5%. Conclusion: When other factors were considered, preoperative airway obstruction predicted the occurrence of bronchospasm, but not prolonged endotracheal intubation, in smokers undergoing abdominal surgery who are treated according to current clinical practices.

Original languageEnglish (US)
Pages (from-to)372-379
Number of pages8
JournalAnesthesiology
Volume90
Issue number2
DOIs
StatePublished - Feb 1999

Fingerprint

Airway Obstruction
Forced Expiratory Volume
Smoking
Bronchial Spasm
Intratracheal Intubation
History
Odds Ratio
Confidence Intervals
Spirometry
Vital Capacity
Critical Care
Ambulatory Surgical Procedures
Medical Records
Reference Values
Logistic Models
Databases
Lung

Keywords

  • Case-control study
  • Chronic obstructive pulmonary disease
  • Emphysema
  • Morbidity
  • Postoperative pulmonary complications

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Airway obstruction and perioperative complications in smokers undergoing abdominal surgery. / Warner, David Oman; Warner, Mark A.; Offord, Kenneth P.; Schroeder, Darrell R.; Maxson, Pamela; Scanlon, Paul D.

In: Anesthesiology, Vol. 90, No. 2, 02.1999, p. 372-379.

Research output: Contribution to journalArticle

Warner, David Oman ; Warner, Mark A. ; Offord, Kenneth P. ; Schroeder, Darrell R. ; Maxson, Pamela ; Scanlon, Paul D. / Airway obstruction and perioperative complications in smokers undergoing abdominal surgery. In: Anesthesiology. 1999 ; Vol. 90, No. 2. pp. 372-379.
@article{02af01a4666744288a82c6844a45441c,
title = "Airway obstruction and perioperative complications in smokers undergoing abdominal surgery",
abstract = "Background: The goal of this study was to determine whether airway obstruction determined by preoperative spirometry predicts perioperative complications in smokers undergoing abdominal surgery whose treatment is managed according to current clinical practice. Methods: A pulmonary function database identified patients undergoing abdominal surgery who met the following criteria for airway obstruction (n = 135): a forced expiratory volume less than 40{\%} of predicted normal value, a forced expiratory volume:forced vital capacity ratio less than the lower limit of predicted normal, a smoking history of more than 20 pack-years, and an age older than 35 yr. A group of patients without airway obstruction (n = 135) was matched for gender, surgical site (upper vs. lower abdominal), smoking history, and age. Medical records were reviewed by an abstractor to identify perioperative complications that occurred within 30 days after surgery. Results: The forced expiratory volume values were 0.9 ± 0.2 l (mean ± SD) and 2.9 ± 0.6 l in patients with and without airway obstruction, respectively. When analyzed by conditional logistic regression using the 1:1 matched-pairs feature, including age, pack-year smoking history, site of incision, and current smoking status as covariates, in patients with airway obstruction bronchospasm was more likely to develop (odds ratio, 6.9 [95{\%} confidence interval, 1.2 to 38.4]) but the patients were not more likely to need prolonged endotracheal intubation (odds ratio, 1.11 [95{\%} confidence interval, 0.4 to 3.2]). They were also no more likely to need prolonged intensive care admission or readmission. The frequency of other complications was less than 5{\%}. Conclusion: When other factors were considered, preoperative airway obstruction predicted the occurrence of bronchospasm, but not prolonged endotracheal intubation, in smokers undergoing abdominal surgery who are treated according to current clinical practices.",
keywords = "Case-control study, Chronic obstructive pulmonary disease, Emphysema, Morbidity, Postoperative pulmonary complications",
author = "Warner, {David Oman} and Warner, {Mark A.} and Offord, {Kenneth P.} and Schroeder, {Darrell R.} and Pamela Maxson and Scanlon, {Paul D}",
year = "1999",
month = "2",
doi = "10.1097/00000542-199902000-00007",
language = "English (US)",
volume = "90",
pages = "372--379",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Airway obstruction and perioperative complications in smokers undergoing abdominal surgery

AU - Warner, David Oman

AU - Warner, Mark A.

AU - Offord, Kenneth P.

AU - Schroeder, Darrell R.

AU - Maxson, Pamela

AU - Scanlon, Paul D

PY - 1999/2

Y1 - 1999/2

N2 - Background: The goal of this study was to determine whether airway obstruction determined by preoperative spirometry predicts perioperative complications in smokers undergoing abdominal surgery whose treatment is managed according to current clinical practice. Methods: A pulmonary function database identified patients undergoing abdominal surgery who met the following criteria for airway obstruction (n = 135): a forced expiratory volume less than 40% of predicted normal value, a forced expiratory volume:forced vital capacity ratio less than the lower limit of predicted normal, a smoking history of more than 20 pack-years, and an age older than 35 yr. A group of patients without airway obstruction (n = 135) was matched for gender, surgical site (upper vs. lower abdominal), smoking history, and age. Medical records were reviewed by an abstractor to identify perioperative complications that occurred within 30 days after surgery. Results: The forced expiratory volume values were 0.9 ± 0.2 l (mean ± SD) and 2.9 ± 0.6 l in patients with and without airway obstruction, respectively. When analyzed by conditional logistic regression using the 1:1 matched-pairs feature, including age, pack-year smoking history, site of incision, and current smoking status as covariates, in patients with airway obstruction bronchospasm was more likely to develop (odds ratio, 6.9 [95% confidence interval, 1.2 to 38.4]) but the patients were not more likely to need prolonged endotracheal intubation (odds ratio, 1.11 [95% confidence interval, 0.4 to 3.2]). They were also no more likely to need prolonged intensive care admission or readmission. The frequency of other complications was less than 5%. Conclusion: When other factors were considered, preoperative airway obstruction predicted the occurrence of bronchospasm, but not prolonged endotracheal intubation, in smokers undergoing abdominal surgery who are treated according to current clinical practices.

AB - Background: The goal of this study was to determine whether airway obstruction determined by preoperative spirometry predicts perioperative complications in smokers undergoing abdominal surgery whose treatment is managed according to current clinical practice. Methods: A pulmonary function database identified patients undergoing abdominal surgery who met the following criteria for airway obstruction (n = 135): a forced expiratory volume less than 40% of predicted normal value, a forced expiratory volume:forced vital capacity ratio less than the lower limit of predicted normal, a smoking history of more than 20 pack-years, and an age older than 35 yr. A group of patients without airway obstruction (n = 135) was matched for gender, surgical site (upper vs. lower abdominal), smoking history, and age. Medical records were reviewed by an abstractor to identify perioperative complications that occurred within 30 days after surgery. Results: The forced expiratory volume values were 0.9 ± 0.2 l (mean ± SD) and 2.9 ± 0.6 l in patients with and without airway obstruction, respectively. When analyzed by conditional logistic regression using the 1:1 matched-pairs feature, including age, pack-year smoking history, site of incision, and current smoking status as covariates, in patients with airway obstruction bronchospasm was more likely to develop (odds ratio, 6.9 [95% confidence interval, 1.2 to 38.4]) but the patients were not more likely to need prolonged endotracheal intubation (odds ratio, 1.11 [95% confidence interval, 0.4 to 3.2]). They were also no more likely to need prolonged intensive care admission or readmission. The frequency of other complications was less than 5%. Conclusion: When other factors were considered, preoperative airway obstruction predicted the occurrence of bronchospasm, but not prolonged endotracheal intubation, in smokers undergoing abdominal surgery who are treated according to current clinical practices.

KW - Case-control study

KW - Chronic obstructive pulmonary disease

KW - Emphysema

KW - Morbidity

KW - Postoperative pulmonary complications

UR - http://www.scopus.com/inward/record.url?scp=0032964035&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032964035&partnerID=8YFLogxK

U2 - 10.1097/00000542-199902000-00007

DO - 10.1097/00000542-199902000-00007

M3 - Article

C2 - 9952139

AN - SCOPUS:0032964035

VL - 90

SP - 372

EP - 379

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 2

ER -