Tags

Type your tag names separated by a space and hit enter

Defining risk of general surgery in patients with chronic obstructive pulmonary diseases.
QJM 2019; 112(2):107-113QJM

Abstract

Background

The relationship between chronic obstructive pulmonary disease (COPD) and perioperative outcomes remains incompletely understood. Our purpose is to evaluate the features of postoperative adverse outcomes for geriatric surgical patients with COPD receiving non-thoracic surgeries.

Aim

To evaluate the potential impact of COPD history on the outcome after general surgery.

Design

A retrospective cohort study with matching procedure by propensity score.

Methods

We conducted a nationwide study of 15 359 COPD patients aged 65 years and older who received major non-thoracic surgeries in 2008-2013 from the Taiwan National Health Insurance Research Database. Comprehensive matching procedure with propensity score were used to select 15 359 surgical patients without COPD for comparison. Major postoperative complications and 30-day in-hospital mortality were evaluated among patients with and without COPD by calculating adjusted odds ratios (ORs) and 95% CIs.

Results

Patients with COPD had significantly increased risk for postoperative complications, including pneumonia (OR = 90.3; 95% CI: 60.3-135), septicemia (OR = 3.11; 95% CI: 2.82-3.43), acute renal failure (OR = 2.53; 95% CI: 2.11-3.02), pulmonary embolism (OR = 2.74; 95% CI: 1.52-4.96), and 30-day postoperative mortality (adjusted OR = 2.09; 95% CI: 1.76-2.50), compared with surgical patients without COPD. Longer length of hospital stay and higher medical expenditures were also noted in COPD patients than those without COPD.

Conclusions

Geriatric patients with COPD showed significantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly twofold when compared with patients without COPD. Our findings remind surgical care team pay more attention to this specific population.

Authors+Show Affiliations

Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.Department of Surgery, China Medical University Hospital, Taichung, Taiwan. Department of Surgery, University of Illinois, Chicago, USA.Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30335177

Citation

Lin, Chao-Shun, et al. "Defining Risk of General Surgery in Patients With Chronic Obstructive Pulmonary Diseases." QJM : Monthly Journal of the Association of Physicians, vol. 112, no. 2, 2019, pp. 107-113.
Lin CS, Chen CY, Yeh CC, et al. Defining risk of general surgery in patients with chronic obstructive pulmonary diseases. QJM. 2019;112(2):107-113.
Lin, C. S., Chen, C. Y., Yeh, C. C., Chung, C. L., Chen, T. L., & Liao, C. C. (2019). Defining risk of general surgery in patients with chronic obstructive pulmonary diseases. QJM : Monthly Journal of the Association of Physicians, 112(2), pp. 107-113. doi:10.1093/qjmed/hcy240.
Lin CS, et al. Defining Risk of General Surgery in Patients With Chronic Obstructive Pulmonary Diseases. QJM. 2019 Feb 1;112(2):107-113. PubMed PMID: 30335177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Defining risk of general surgery in patients with chronic obstructive pulmonary diseases. AU - Lin,Chao-Shun, AU - Chen,Chien-Yu, AU - Yeh,Chun-Chieh, AU - Chung,Chi-Li, AU - Chen,Ta-Liang, AU - Liao,Chien-Chang, PY - 2018/07/09/received PY - 2018/10/20/pubmed PY - 2019/2/14/medline PY - 2018/10/19/entrez SP - 107 EP - 113 JF - QJM : monthly journal of the Association of Physicians JO - QJM VL - 112 IS - 2 N2 - Background: The relationship between chronic obstructive pulmonary disease (COPD) and perioperative outcomes remains incompletely understood. Our purpose is to evaluate the features of postoperative adverse outcomes for geriatric surgical patients with COPD receiving non-thoracic surgeries. Aim: To evaluate the potential impact of COPD history on the outcome after general surgery. Design: A retrospective cohort study with matching procedure by propensity score. Methods: We conducted a nationwide study of 15 359 COPD patients aged 65 years and older who received major non-thoracic surgeries in 2008-2013 from the Taiwan National Health Insurance Research Database. Comprehensive matching procedure with propensity score were used to select 15 359 surgical patients without COPD for comparison. Major postoperative complications and 30-day in-hospital mortality were evaluated among patients with and without COPD by calculating adjusted odds ratios (ORs) and 95% CIs. Results: Patients with COPD had significantly increased risk for postoperative complications, including pneumonia (OR = 90.3; 95% CI: 60.3-135), septicemia (OR = 3.11; 95% CI: 2.82-3.43), acute renal failure (OR = 2.53; 95% CI: 2.11-3.02), pulmonary embolism (OR = 2.74; 95% CI: 1.52-4.96), and 30-day postoperative mortality (adjusted OR = 2.09; 95% CI: 1.76-2.50), compared with surgical patients without COPD. Longer length of hospital stay and higher medical expenditures were also noted in COPD patients than those without COPD. Conclusions: Geriatric patients with COPD showed significantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly twofold when compared with patients without COPD. Our findings remind surgical care team pay more attention to this specific population. SN - 1460-2393 UR - https://www.unboundmedicine.com/medline/citation/30335177/Defining_risk_of_general_surgery_in_patients_with_chronic_obstructive_pulmonary_diseases_ L2 - https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/hcy240 DB - PRIME DP - Unbound Medicine ER -