Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study

被引：13

作者：

Piccioni, Federico ^{[1
]}

Spagnesi, Lorenzo ^{[2
]}

Pelosi, Paolo ^{[3
,4
]}

Bignami, Elena ^{[5
]}

Guarnieri, Marcello ^{[6
]}

Fumagalli, Luca ^{[7
]}

Polati, Enrico ^{[8
]}

Schweiger, Vittorio ^{[8
]}

Comi, Daniela ^{[9
]}

D'andrea, Rocco ^{[10
]}

Di Marco, Pierangelo ^{[11
]}

Spadaro, Savino ^{[12
]}

Antonelli, Serena ^{[13
]}

Sollazzi, Liliana ^{[14
,15
]}

Mirabella, Lucia ^{[16
]}

Schiavoni, Marina ^{[17
]}

Laici, Cristiana ^{[18
]}

Marelli, Jlenia A. ^{[19
]}

Fabiani, Fabio ^{[20
]}

Ball, Lorenzo ^{[3
,4
]}

Roasio, Agostino ^{[21
]}

Servillo, Giuseppe ^{[22
]}

Franchi, Matteo ^{[23
]}

Murino, Patrizia ^{[24
]}

Irone, Marco ^{[25
]}

Parrini, Vieri ^{[26
]}

De Cosmo, Germano ^{[27
]}

Cornara, Giuseppe ^{[28
]}

Ruberto, Franco ^{[29
]}

Pasta, Gilda ^{[30
]}

Ferrari, Lorenzo ^{[31
]}

Greco, Massimiliano ^{[1
,32
]}

Cecconi, Maurizio ^{[1
,32
]}

Della Rocca, Giorgio ^{[33
]}

机构：

[1] IRCCS Humanitas Res Hosp, Dept Anesthesia & Intens Care, Anesthesia Unit 1, Via Manzoni 56, I-20089 Milan, Italy

[2] Azienda Sanit Univ Friuli Cent, Sect Anesthesia & Intens Care Med Clin, Udine, Italy

[3] Univ Genoa, Dept Surg Sci & Integrated Diagnost, Genoa, Italy

[4] IRCCS San Martino Univ Hosp, Anesthesia & Crit Care, Genoa, Italy

[5] Univ Parma, Dept Med & Surg, Anesthesiol Crit Care & Pain Med Div, Parma, Italy

[6] IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Milan, Italy

[7] Fdn IRCCS Ist Nazl Tumori, Dept Crit & Support Therapy, Milan, Italy

[8] Univ Verona, Sect Anesthesia Intens Care & Pain Therapy, Dept Surg Dent Pediat & Gynecol, Verona, Italy

[9] ASST Papa Giovanni XXIII, Anesthesia & Intens Care Unit, Bergamo, Italy

[10] IRCCS Azienda Osped Univ Bologna, Dept Anesthesia Intens Care & Emergency, Bologna, Italy

[11] Sapienza Univ, Dept Clin Anesthesiol & Cardiovasc Sci, Rome, Italy

[12] Univ Ferrara, Ferrara Univ Hosp, Dept Translat Med, Anesthesia & Intens Care Unit, Ferrara, Italy

[13] Campus Biomed Fdn Rome, Dept Med, Unit Anesthesia Intens Care & Pain Management, Rome, Italy

[14] IRCCS A Gemelli Univ Polyclin Fdn, Dept Emergency Med Anesthesiol & Resuscitat, Rome, Italy

[15] Univ Cattolica Sacro Cuore, IRCCS Roma, Rome, Italy

[16] Univ Foggia, Dept Med & Surg Sci, Intens Care Unit, Foggia, Italy

[17] Giovanni XXIII Polyclin Hosp, Anesthesia & Intens Care Unit 1, Bari, Italy

[18] IRCCS Azienda Osped Univ Bologna, Postoperat & Abdominal Organ Transplant Intens Ca, Bologna, Italy

[19] Azienda Socio Sanit Terr Lariana, Dept Emergency Med Anesthesia & Resuscitat, Unit Anesthesia & Resuscitat 2, Como, Italy

[20] Ctr Riferimento Oncol Aviano IRCCS, Anesthesia & Intens Care Med, Aviano, Pordenone, Italy

[21] Cardinal Massaia Hosp, Anesthesia & Intens Care Unit, Asti, Italy

[22] Univ Naples Federico II, Dept Neurosci Reprod & Odontostomatol Sci, Naples, Italy

[23] Versilia Hosp, Azienda Usl Toscana Nordovest, Anesthesia & Intens Care Unit, Camaiore, Lucca, Italy

[24] Monaldi Hosp, Crit Area Dept, Azienda Osped Specialist Colli, Anesthesia Unit, Naples, Italy

[25] San Bortolo Hosp, Unit Anesthesia & Resuscitat, Vicenza, Italy

[26] Del Mugello Hosp, USL Toscana Ctr, Anesthesia & Intens Care Unit, Florence, Italy

[27] Sacred Heart Catholic Univ, Anesthesia & Intens Care Inst, Rome, Italy

[28] ASO S Croce & Carle, Anesthesia & Intens Care Unit, Cuneo, Italy

[29] Sapienza Univ, Umberto Polyclin Hosp 1, Paride Stefanini Dept Gen & Specialist Surg, Rome, Italy

[30] Ist Nazl Tumori IRCCS Fdn Pascale, Div Anesthesia Pain Med & Support Care, Naples, Italy

[31] Azienda USL IRCCS Reggio Emilia, Anesthesia & Intens Care Unit, Reggio Emilia, Italy

[32] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[33] Univ Udine, Dept Med Area, Udine, Italy

来源：

MINERVA ANESTESIOLOGICA | 2023年 / 89卷 / 11期

关键词：

Anesthesia; Lungs; Gynecologic surgical procedures; Postoperative Complications; Urologic surgical procedures; General surgery; RISK CALCULATOR; VENTILATION; VALIDATION; EPIDEMIOLOGY; PREDICTION; INJURY; TRIAL; SCORE;

D O I：

10.23736/S0375-9393.23.17382-2

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease.METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality. RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre-and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001).CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.

引用

页码：964 / 976

页数：13

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