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Predictors of pulmonary complications after bariatric surgery

Prateek K Gupta1, Himani Gupta, Manu Kaushik

  • 1Department of Surgery, Creighton University, Omaha, Nebraska, USA.

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
|July 2, 2011
PubMed

Insights

Postoperative pneumonia and respiratory failure are uncommon after bariatric surgery but significantly increase morbidity and mortality. Preoperative factors like heart failure and stroke can predict these serious complications.

Area of Science:

  • Bariatric Surgery Outcomes
  • Pulmonary Complications
  • Surgical Risk Factors

Background:

  • Postoperative pneumonia (PP) and respiratory failure (PRF) are the most frequent non-wound complications following bariatric surgery.
  • Identifying the prevalence and predictive preoperative factors for PP and PRF is crucial for patient management.

Purpose of the Study:

  • To determine the current prevalence of postoperative pneumonia and respiratory failure after bariatric surgery.
  • To identify preoperative risk factors associated with the development of PP and PRF.

Main Methods:

  • Utilized data from the American College of Surgeons' National Surgical Quality Improvement Program (2006-2008).
  • Included patients undergoing bariatric surgery.
  • Performed univariate and multivariate logistic regression analyses to identify risk factors.

Main Results:

  • Postoperative pneumonia (PP) occurred in 0.6% of 32,889 patients; respiratory failure (PRF) occurred in 0.6%.
  • PP and PRF accounted for 18.7% of the total 30-day morbidity and were associated with significantly increased 30-day mortality and longer hospital stays.
  • Preoperative congestive heart failure and stroke were major risk factors for PP, while previous percutaneous coronary intervention and dyspnea at rest were strongly associated with PRF. Other factors included bleeding disorder, age, COPD, surgery type, smoking, diabetes, anesthesia time, and weight.

Conclusions:

  • Despite being infrequent, PP and PRF contribute significantly to postoperative morbidity and mortality after bariatric procedures.
  • Various preoperative risk factors can predict PP and PRF, highlighting the necessity of patient optimization and careful selection prior to surgery.
Abstract

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