Chest
Clinical Investigations: Cardiology Cardio-Thoracic Surgery: Comparative Study: Journal ArticlePostoperative Complications After Thoracic and Major Abdominal Surgery in Patients With and Without Obstructive Lung Disease
Section snippets
Methods
The study site was Brooke Army Medical Center, a 692-bed teaching hospital in Texas that serves active-duty and retired military personnel and their dependents. From 107 elective operations performed in patients with severe COPD at Brooke between January 1986 and September 1988,17 we focused on the 31 nonresectional thoracic and major abdominal procedures. In 26 of these, we had complete hospital records and for 5, detailed narrative summaries. These latter five patients had been transferred
Postoperative Complications
Operative outcome is summarized in Table 2. Patients with severe COPD were more likely to experience bronchospasm (p = 0.002) and supraventricular tachyarrhythmias (p = 0.01). However, the frequency of most individual complications was too low for the differences to reach statistical significance, so complications were grouped and analyzed by category. Rates of minor pulmonary (grade 1 or 2), cardiac, and vascular complications were similar among study groups. Vascular complications consisted
Discussion
In patients undergoing thoracic and major abdominal operations, COPD was associated with an increased risk of serious pulmonary complications and death. On the other hand, severity of COPD did not affect the incidence of the more frequent cardiac and low-grade pulmonary complications. Spirometry per se was not an independent predictor, whereas the clinical variables of higher ASA class, increasing age, abnormal chest radiograph, and bronchodilator administration were significantly associated
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The opinions or assertions herein are the private views of the author and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.