Risk factors for pulmonary complications after emergency abdominal surgery

Respir Med. 2007 Apr;101(4):808-13. doi: 10.1016/j.rmed.2006.07.015. Epub 2006 Sep 8.


Objective: Pulmonary complications are common after abdominal surgery. Although a variety of risk factors have been described for these complications, studies so far have focused on elective interventions. The aim of this study was to determine the incidence and predictors of pulmonary complications following emergency abdominal surgery.

Methods: This was a prospective cohort study. Pre and intra-operative data were collected through interview and chart review and their association with the occurrence of postoperative pulmonary complications (PPC) were analyzed.

Results: Two hundred and sixty-six consecutive adult patients were included and seventy-five (28.2%) developed PPC. Age >50 years (adjusted OR=3.86; P<0.001), body mass index (BMI) <21 kg/m(2) or 30 kg/m(2) (adjusted OR=2.43; P=0.007) and upper or upper/lower abdominal incision (adjusted OR=2.57; P=0.027) were independently associated with PPC. Patients submitted to multiple procedures tended to be at a higher risk for PPC (adjusted OR=1.73; P=0.079). The development of PPC was associated with prolonged hospital stay (P<0.001) and increased death rate (P<0.001).

Conclusions: Pulmonary complications are frequent among patients undergoing abdominal emergency surgery and lead to increased length of hospital stay and death rate. Older age, abnormal BMI, upper or upper/lower abdominal incision and multiple procedures are predictors of PPC in this setting.

MeSH terms

  • Abdomen / surgery*
  • Abdominal Injuries / complications
  • Abdominal Injuries / surgery
  • Adult
  • Age Factors
  • Emergencies*
  • Female
  • Humans
  • Length of Stay
  • Lung Diseases / etiology*
  • Male
  • Middle Aged
  • Pleural Effusion / etiology
  • Pneumonia / etiology
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Pulmonary Atelectasis / etiology
  • Respiratory Insufficiency / etiology
  • Respiratory Tract Diseases / etiology*
  • Risk Factors
  • Surgical Procedures, Operative / methods