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Incidence of postoperative pulmonary complications and associated risk factors after major oncosurgeries: Prospective
Shilpi Agarwal1, Rakesh Garg, Sushma Bhatnagar
1Department of Onco-Anaesthesia and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Background:
Postoperative pulmonary complications (PPCs) are defined heterogeneously and have major adverse effects in increasing morbidity. Oncosurgeries themselves are complex, are of long duration, and extensive handling of body tissues occurs in them, leading to various complications including PPCs. So, we conducted this prospective study intending to find the incidence and risk factors for PPCs in patients undergoing major oncosurgeries.
Methods:
This prospective observational study was conducted after obtaining institutional ethical approval in patients undergoing major oncosurgeries. The demographic, preoperative, and intraoperative details were noted, and patients were followed in the postoperative period for the occurrence of PPC till discharge. Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score was used to predict the occurrence of PPC. Data were analyzed using multivariable regression analysis for the risk factors, and the Chi-square trend was used to see the trend of PPC with the change in ARISCAT score.
Results:
The overall incidence of PPC in patients undergoing major oncosurgeries was 28.05%. The most common PPCs were respiratory insufficiency (19.2%) and atelectasis (17.6%). The highest incidence of PPC was found in thoracotomies (41.6%), followed by cytoreductive surgeries (40.6%). The risk factors for PPCs included body mass index (BMI) <18.5 or >25 kg/m2, smoking, use of nasogastric tube, age >60 years, and albumin <3.5 g/dL. Patients with low ARISCAT scores had a low incidence of PPC compared to those with high and intermediate ARISCAT scores.
Conclusion:
The incidence of PPC in patients undergoing major oncosurgeries was 28.05% in our study. The independent risk factors for PPC in oncological surgeries were BMI <18.5 kg/m2 or >25 kg/m2, use of nasogastric tube, age <60 years, serum albumin <3.5 g/dL, and smoking.
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