Preoperative Exposure to Fine Particulate Matter and Risk of Postoperative Complications: A Single Center...

Area of Science:

• Environmental Health
• Surgical Outcomes Research
• Epidemiology

Background:

• Fine particulate matter air pollution (PM2.5) is linked to adverse health effects.
• The impact of perioperative PM2.5 exposure on postoperative outcomes in US adults is understudied.
• PM2.5 may induce inflammation, interacting with surgical stress to increase complications.

Purpose of the Study:

• To investigate the association between perioperative PM2.5 exposure and postoperative complications.
• To determine if elevated PM2.5 concentrations in the week prior to surgery increase the risk of major postoperative complications.

Main Methods:

• Retrospective cohort study of 49,615 elective surgical patients at a single academic medical center (2016-2018).
• Patient addresses were geocoded and linked to daily Census-tract level PM2.5 estimates.
• Hierarchical Bayesian regression adjusted for demographics, season, neighborhood disadvantage, and comorbidities.

Main Results:

• Postoperative complications increased in a dose-dependent manner with higher PM2.5 exposure.
• An 8% increase in odds of complications for every 10ug/m³ increase in highest single-day PM2.5 exposure (7 days pre-op).
• A 30-fold PM2.5 increase (1 to 30ug/m³) raised complication odds by over 27%; association persisted after confounder control.

Conclusions:

• Elevated PM2.5 exposure pre-surgery is associated with increased postoperative complications in a dose-dependent manner.
• Air pollution may be a significant perioperative risk factor, impacting surgical outcomes.
• Further research in larger datasets is needed to identify at-risk populations and understand pollutant interactions.