Preoperative spirometry to predict postoperative complications in thoracic surgery patients

Spirometry is a simple and basic test that can provide more information about pulmonary function. Many thoracic surgeons do a spirometry test to assess the pulmonary status of their patients before surgery.

To determine if preoperative spirometry can predict postoperative complications following thoracic surgery.

Retrospective case control study.

Srinagarind Hospital Medical School, Khon Kaen University, Khon Kaen Thailand.

Adult patients who had spirometry before thoracic surgery.

From 1995 to 1998, we reviewed thoracic surgery patients who had spirometry testing before thoracic surgery. Fifty-six patients were enrolled in our study. Postoperative complications of these patients were determined by a systemic extraction of medical record data. The postoperative complications were classified into two groups, respiratory and non-respiratory complications. Eighteen patients experienced at least one respiratory and other complications. There was a sixfold or greater increase in non-respiratory complications (cardiac arrhythmia, congestive heart failure, prolonged hospital stay, upper gastrointestinal bleeding and wound infection), which were associated with moderate and severe impairment of FEV1 and FVC (< 66% predicted) (P < 0.05). There was a thirty percent increase in non-respiratory complications, which were associated with FEV1 < 2 liters (p < 0.05), FEV1 or FVC less than 70 per cent of predicted value (p < 0.05). No spirometric values were a good predictor of respiratory complications.

Preoperative spirometry levels in patients requiring thoracic surgery of FEV1 < 2 liters, FEV1 or FVC < 70 per cent of predicted value was associated with postoperative complications, especially non-respiratory complications.