Kaleem Ullah Toori, Jahangir Sarwar Khan, Ali Zohair Nomani, Syed Waqar Hussain, Saad Hashmi.
A prospective study of factors predicting postoperative pulmonary complications (PPC) in patients undergoing noncardiothoracic surgery under general anaesthsia in a developing country.
Anesth Pain Intens Care Jan ;16(3):252-6.

Introduction: Post-operative pulmonary complications after non-cardiothoracic surgery are common and can adversely affect morbidity, mortality and length of hospital stay. Knowledge as regards factors predicting postoperative pulmonary complications in our local setting is imperfect. Aims & Objectives: To study factors predicting post-operative pulmonary complications in developing countries. Methodology: Data of consecutive 404 patients undergoing non-cardiothoracic surgery under general anesthesia with tracheal intubation was collected prospectively from Jan 2009 to Dec 2010. Chi-square was used for univariate analysis. Multivariate analysis was conducted using forward stepwise logistic regression. Results: The mean age was 36±18 years with slight male predominence (54% vs 46%). 22% (n=89) were smokers and the mean Body Mass Index was 23±4.5 kg/m2 with 35% (n=141) overweight & obese. 5% (n=20) of subjects had pre-existing chronic lung conditions while 23% (n=92) had non-pulmonary chronic conditions. 70% (n=282) of the surgeries were done electively and the mean duration of anesthesia was 78±44 minutes. The overall postoperative pulmonary complications rate was 8% (n=31) with atelactasis (48%, n=16) followed by bronchospasm (25%, n=8) and pneumonia (16%, n=5) being the commonest complications. The duration of hospital stay was significantly longer (11±9 days, p=0.00) in patients with post-operative pulmonary complications and 29% (n=9) of them required mechanical ventilation. Logistic Regression analysis identified premorbid chronic chest conditions, emergency surgery and prolonged duration of anesthesia as significant predictors of post-operative pulmonary complications while age, gender, Body Mass Index, smoking history and non-pulmonary premorbids were insignificant in this regard. Conclusion: Post-operative pulmonary complications after non-cardiothoracic surgery are common and lead to increased morbidity and prolonged hospital stay in our setting. We identified pre-existing chest disease, prolonged anesthesia and emergency surgery as significant predictors of post-operative pulmonary complications.

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