Airflow limitation severity and post‐operative pulmonary complications following extra‐pulmonary surgery in COPD patients. Issue 5 (24th January 2017)

• Record Type: Journal Article
• Authors: Shin, Beomsu; Lee, Hyun; Kang, Danbee; Jeong, Byeong‐Ho; Kang, Hyung Koo; Chon, Hae Ri; Koh, Won‐Jung; Chung, Man Pyo; Guallar, Eliseo; Cho, Juhee; Park, Hye Yun
• Is Part Of: Respirology. Volume 22:Issue 5(2017)
• Page Start: 935
• Page End: 941
• Publication Date: 2017-01-24
• Subjects: chronic obstructive pulmonary disease -- complications -- spirometry -- surgery; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.12988
• Languages: English
• ISSNs: 1323-7799

Abstract

ABSTRACT: Background and objective: The association between airflow limitation severity and post‐operative pulmonary complications (PPCs) among COPD patients undergoing extra‐pulmonary surgery is unknown. We evaluated the association between forced expiratory volume in 1 s (FEV1 ) and PPC in COPD patients undergoing extra‐pulmonary surgery. Methods: Using prospective cohort of PPC evaluation for extra‐pulmonary surgery, we identified 694 COPD patients who conducted PPC evaluation before extra‐pulmonary surgery between March 2014 and January 2015 at a tertiary hospital, Seoul, Korea. Results: The overall incidence of PPC was 24.4%. The incidence of PPC in quintiles 1–5 of FEV1 (% predicted) was 31.4, 25.8, 23.7, 21.6 and 19.7%, respectively ( P for trend: 0.019). In fully adjusted multivariable models, the relative risks (RRs, 95% CI) for PPC comparing participants in quintiles 1–4 of FEV1 (% predicted) with those in quintile 5 were 1.69 (1.03–2.79), 1.41 (0.83–2.37), 1.26 (0.75–2.11) and 1.30 (0.76–2.22), respectively ( P for trend: 0.046). The association of severe airflow limitation with respiratory failure and post‐operative exacerbations was stronger in participants who did not use bronchodilators compared with those who did. Conclusion: We found a progressive and significant relationship between severity of airflow limitation and the incidence of PPC in COPD patients undergoing extra‐pulmonary surgery. Furthermore, perioperative bronchodilator use was associated with a reduced risk of respiratory failure and post‐operative exacerbations in patients with severe airflow limitation. Abstract : A progressive and significant relationship was demonstrated between severity of airflow limitation and the incidence of post‐operative pulmonary complications in COPD patients undergoing extra‐pulmonary surgery. Perioperative bronchodilator use was associated with a reduced risk of respiratory failure and post‐operative exacerbations in patients with severe airflow limitation.