BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease.METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality. RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre-and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001).CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.

Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study / Piccioni, F.; Spagnesi, L.; Pelosi, P.; Bignami, E.; Guarnieri, M.; Fumagalli, L.; Polati, E.; Schweiger, V.; Comi, D.; D'Andrea, R.; Di Marco, P.; Spadaro, S.; Antonelli, S.; Sollazzi, L.; Mirabella, L.; Schiavoni, M.; Laici, C.; Marelli, J. A.; Fabiani, F.; Ball, L.; Roasio, A.; Servillo, G.; Franchi, M.; Murino, P.; Irone, M.; Parrini, V.; de Cosmo, G.; Cornara, G.; Ruberto, F.; Pasta, G.; Ferrari, L.; Greco, M.; Cecconi, M.; della Rocca, G.; Aceto, P.; Adrario, E.; Artico, C.; Baravelli, A.; Barbariol, F.; Bettonte, P.; Bianchin, A.; Bifulco, F.; Brienza, N.; Buttazzoni, M.; Cataldo, R.; Copetti, E.; Cornara, P.; Cuomo, A.; de Negri, P.; Del Vicario, M.; Domini, M.; Dusi, F.; Faliva, A.; Forfori, F.; Franco, A.; Gianni, S.; Guasti, G.; Iacobone, E.; Lo Martire, N.; Lombardo, A.; Lorini, F. L.; Maucione, A.; Mazzoli, C. A.; Migliavacca, S.; Miglio, F.; Molin, A.; Nese, A.; Oggiano, M.; Papagni, G.; Pecchia, M.; Perilli, V.; Previtali, P.; Prizio, G.; Punzo, G.; Rainaldi, M. P.; Rigillo, G.; Sacco, T.; Santagata, C.; Serena, G.; Siniscalchi, A.; Toninelli, A.; Toretti, I.; Tullo, L.; Vargas, M.; Zanier, C.; Zocca, E.. - In: MINERVA ANESTESIOLOGICA. - ISSN 0375-9393. - 89:11(2023), pp. 964-976. [10.23736/S0375-9393.23.17382-2]

Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study

Bignami E.;D'Andrea R.;Di Marco P.;Antonelli S.;Schiavoni M.;Servillo G.;Ruberto F.;della Rocca G.;Cataldo R.;Domini M.;Perilli V.;Siniscalchi A.;Tullo L.;Vargas M.;
2023

Abstract

BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease.METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality. RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre-and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001).CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.
2023
Anesthesia; Lungs; Gynecologic surgical procedures; Postoperative Complications; Urologic surgical procedures; General surgery
01 Pubblicazione su rivista::01a Articolo in rivista
Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study / Piccioni, F.; Spagnesi, L.; Pelosi, P.; Bignami, E.; Guarnieri, M.; Fumagalli, L.; Polati, E.; Schweiger, V.; Comi, D.; D'Andrea, R.; Di Marco, P.; Spadaro, S.; Antonelli, S.; Sollazzi, L.; Mirabella, L.; Schiavoni, M.; Laici, C.; Marelli, J. A.; Fabiani, F.; Ball, L.; Roasio, A.; Servillo, G.; Franchi, M.; Murino, P.; Irone, M.; Parrini, V.; de Cosmo, G.; Cornara, G.; Ruberto, F.; Pasta, G.; Ferrari, L.; Greco, M.; Cecconi, M.; della Rocca, G.; Aceto, P.; Adrario, E.; Artico, C.; Baravelli, A.; Barbariol, F.; Bettonte, P.; Bianchin, A.; Bifulco, F.; Brienza, N.; Buttazzoni, M.; Cataldo, R.; Copetti, E.; Cornara, P.; Cuomo, A.; de Negri, P.; Del Vicario, M.; Domini, M.; Dusi, F.; Faliva, A.; Forfori, F.; Franco, A.; Gianni, S.; Guasti, G.; Iacobone, E.; Lo Martire, N.; Lombardo, A.; Lorini, F. L.; Maucione, A.; Mazzoli, C. A.; Migliavacca, S.; Miglio, F.; Molin, A.; Nese, A.; Oggiano, M.; Papagni, G.; Pecchia, M.; Perilli, V.; Previtali, P.; Prizio, G.; Punzo, G.; Rainaldi, M. P.; Rigillo, G.; Sacco, T.; Santagata, C.; Serena, G.; Siniscalchi, A.; Toninelli, A.; Toretti, I.; Tullo, L.; Vargas, M.; Zanier, C.; Zocca, E.. - In: MINERVA ANESTESIOLOGICA. - ISSN 0375-9393. - 89:11(2023), pp. 964-976. [10.23736/S0375-9393.23.17382-2]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1710151
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 7
social impact