Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery

Sao Paulo Med J. 1999 Jul 1;117(4):151-60. doi: 10.1590/s1516-31801999000400003.


Objective: To investigate associations between preoperative variables and postoperative pulmonary complications (PPC) in elective upper abdominal surgery.

Design: Prospective clinical trial.

Setting: A tertiary university hospital.

Patients: 408 patients were prospectively analyzed during the preoperative period and followed up postoperatively for pulmonary complications.

Measurements: Patient characteristics, with clinical and physical evaluation, related diseases, smoking habits, and duration of surgery. Preoperative pulmonary function tests (PFT) were performed on 247 patients.

Results: The postoperative pulmonary complication rate was 14 percent. The significant predictors in univariate analyses of postoperative pulmonary complications were: age >50, smoking habits, presence of chronic pulmonary disease or respiratory symptoms at the time of evaluation, duration of surgery >210 minutes and comorbidity (p <0.04). In a logistic regression analysis, the statistically significant predictors were: presence of chronic pulmonary disease, surgery lasting >210 and comorbidity (p <0.009).

Conclusions: There were three major clinical risk factors for pulmonary complications following upper abdominal surgery: chronic pulmonary disease, comorbidity, and surgery lasting more than 210 minutes. Those patients with three risk factors were three times more likely to develop a PPC compared to patients without any of these risk factors (p <0.001). PFT is indicated when there are uncertainties regarding the patient's pulmonary status.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Chronic Disease
  • Female
  • Humans
  • Logistic Models
  • Lung Diseases / etiology*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Risk Factors
  • Spirometry