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 language | English (US) |
|---|---|
| Pages (from-to) | 372-379 |
| Number of pages | 8 |
| Journal | Anesthesiology |
| Volume | 90 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1999 |
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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 journal › Article
}
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 -