Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients

Beomsu Shin, Hyun Lee, Danbee Kang, Byeong Ho Jeong, Hyung Koo Kang, Hae Ri Chon, Won Jung Koh, Man Pyo Chung, Eliseo Guallar, Juhee Cho, Hye Yun Park

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)935-941
Number of pages7
JournalRespirology
Volume22
Issue number5
DOIs
StatePublished - Jul 2017

Keywords

  • chronic obstructive pulmonary disease
  • complications
  • spirometry
  • surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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