Pulmonary function testing in preoperative high-risk patients

Area of Science:

• Anesthesiology
• Pulmonology
• Geriatric Medicine

Background:

• Postoperative respiratory failure is a common complication in surgical patients.
• Preoperative assessment is crucial for identifying patients at risk.
• Pulmonary function testing can reveal underlying respiratory issues.

Purpose of the Study:

• To evaluate if preoperative pulmonary function testing detects unknown respiratory impairments in high-risk surgical patients.
• To assess the impact of these impairments on patient outcomes.

Main Methods:

• Spirometry and diffusing capacity of the lung for carbon monoxide (D_LCO) screening were performed in patients aged ≥75 or with reduced exercise tolerance (MET < 4).
• Clinical data, lung disease history, and smoking status were recorded.
• Statistical analyses included t-tests, ANOVA, and multiple linear regression.

Main Results:

• 35.2% of patients had previously unknown obstructive ventilatory disorders (65 cases).
• 27.6% had previously unknown gas exchange impairments (40 cases).
• Lower pulmonary function parameters (FVC, FEV₁, D_LCO) were associated with reduced exercise tolerance and lower ASA class.

Conclusions:

• Preoperative screening effectively identified previously unknown lung conditions in high-risk patients.
• These newly diagnosed impairments are linked to reduced exercise capacity and may affect perioperative outcomes.
• Further multicenter studies are needed to determine if optimized management improves outcomes.