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Impact of Chronic Obstructive Pulmonary Disease on Laparoscopic Hysterectomy Outcome.
JSLS 2019 Jan-Mar; 23(1)JSLS

Abstract

Background and Objectives

Limited research exists on the association between chronic obstructive pulmonary disease (COPD) and morbidity and mortality after laparoscopic hysterectomy. The objective of this study is to examine the following: 1) which demographics and comorbidities are most likely to present concurrently in patients with COPD? 2) Are patients with COPD undergoing laparoscopic hysterectomy at increased risk for development of postoperative complications within 30 days?

Methods

Retrospective cohort study using data collected from 2007 to 2016 from the American College of Surgeons National Surgical Quality Improvement Program database. All patients who underwent laparoscopic hysterectomy were identified by Current Procedural Terminology codes and stratified based on COPD status. Univariate and multivariate analyses were completed to define odds ratios for postoperative complications within 30 days of laparoscopic hysterectomy.

Results

This study included 100,518 laparoscopic hysterectomy patients (COPD = 1,130 [1.12%]); (no COPD = 99,388 [98.8%]). Patients with COPD developed more postoperative complications, including pneumonia, reintubation, renal insufficiency, and sepsis. COPD was identified as an independent risk factor for pneumonia (OR, 4.098; 95% CI, 2.222-7.519) and reintubation (OR, 4.348; 95% CI, 2.387-7.937). Patients with COPD had extended length of hospital stay.

Conclusion

Patients with COPD who undergo laparoscopic hysterectomy have increased risk of experiencing postoperative pneumonia, reintubation, renal insufficiency, and sepsis. Overall, postoperative complication rates remain low, but gynecologists should consider the pulmonary disease status of patients when assessing preoperative risk.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30675099

Citation

Galvis, Jensen N., et al. "Impact of Chronic Obstructive Pulmonary Disease On Laparoscopic Hysterectomy Outcome." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 23, no. 1, 2019.
Galvis JN, Vargas MV, Robinson HN, et al. Impact of Chronic Obstructive Pulmonary Disease on Laparoscopic Hysterectomy Outcome. JSLS. 2019;23(1).
Galvis, J. N., Vargas, M. V., Robinson, H. N., Tyan, P., Gu, A., Wei, C., ... Moawad, G. (2019). Impact of Chronic Obstructive Pulmonary Disease on Laparoscopic Hysterectomy Outcome. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 23(1), doi:10.4293/JSLS.2018.00089.
Galvis JN, et al. Impact of Chronic Obstructive Pulmonary Disease On Laparoscopic Hysterectomy Outcome. JSLS. 2019;23(1) PubMed PMID: 30675099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Chronic Obstructive Pulmonary Disease on Laparoscopic Hysterectomy Outcome. AU - Galvis,Jensen N, AU - Vargas,Maria V, AU - Robinson,Hannah N, AU - Tyan,Paul, AU - Gu,Alex, AU - Wei,Chapman, AU - Janakiram,Nikhila, AU - Moawad,Gaby, PY - 2019/1/25/entrez PY - 2019/1/25/pubmed PY - 2019/3/19/medline KW - COPD KW - Chronic obstructive KW - Complications KW - Hysterectomy KW - Pulmonary disease JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 23 IS - 1 N2 - Background and Objectives: Limited research exists on the association between chronic obstructive pulmonary disease (COPD) and morbidity and mortality after laparoscopic hysterectomy. The objective of this study is to examine the following: 1) which demographics and comorbidities are most likely to present concurrently in patients with COPD? 2) Are patients with COPD undergoing laparoscopic hysterectomy at increased risk for development of postoperative complications within 30 days? Methods: Retrospective cohort study using data collected from 2007 to 2016 from the American College of Surgeons National Surgical Quality Improvement Program database. All patients who underwent laparoscopic hysterectomy were identified by Current Procedural Terminology codes and stratified based on COPD status. Univariate and multivariate analyses were completed to define odds ratios for postoperative complications within 30 days of laparoscopic hysterectomy. Results: This study included 100,518 laparoscopic hysterectomy patients (COPD = 1,130 [1.12%]); (no COPD = 99,388 [98.8%]). Patients with COPD developed more postoperative complications, including pneumonia, reintubation, renal insufficiency, and sepsis. COPD was identified as an independent risk factor for pneumonia (OR, 4.098; 95% CI, 2.222-7.519) and reintubation (OR, 4.348; 95% CI, 2.387-7.937). Patients with COPD had extended length of hospital stay. Conclusion: Patients with COPD who undergo laparoscopic hysterectomy have increased risk of experiencing postoperative pneumonia, reintubation, renal insufficiency, and sepsis. Overall, postoperative complication rates remain low, but gynecologists should consider the pulmonary disease status of patients when assessing preoperative risk. SN - 1938-3797 UR - https://www.unboundmedicine.com/medline/citation/30675099/Impact_of_Chronic_Obstructive_Pulmonary_Disease_on_Laparoscopic_Hysterectomy_Outcome_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30675099/ DB - PRIME DP - Unbound Medicine ER -