Kardiyotorasik dışı cerrahilerde postoperatif pulmoner komplikasyonlar

Yıl 2021, Cilt: 14 Sayı: 1, 31 - 41, 04.01.2021

Esra Büyük Derya Hoşgün , Evrim Akpınar Sümeyye Bekir

https://doi.org/10.31362/patd.737172

Öz

Abstract
Purpose:Postoperative pulmonary complications (PPCs) are a majör cause of mortality and morbidity.Aim of the study to evaluate frequencies and determine risk factors of PPCs which developed subsequent to general surgery and orthopedic surgery in a tertiary university hospital.
Materials- Methods:Patients who were operated in Departments of General Surgery and Orthopedics and Traumatology were retrospectively included to the study.
Results: 683 patients with a mean age of 59.43 ± 18.77 years were included in the study. The ratio of PPC was 10.3%. Most frequent PPC was found to be pneumonia ( 6.3%).The prevelance of PPC was significantly higher in patients ≥ 65 years than who were <65 years old (18.2% vs 4.4%) (p<0.001). PPC was more frequent in patients who undergone urgent surgery than those who undergone elective surgery (24.1% vs 8%) (p<0.001).The rates of development of PPC according to the duration of opera-tion (30 min-1 h, 1-2 h, 2-3 h, 3-4 h, >4 h ) were respectively as follows 2.8%, 9.5%, 25%, 75% and 100% (p<0.001). Multivariable logistic regression analysis showed that being ≥ 65 years, having ASA≥3 and hypoalbuminemia (<3g/dl) were independent risk factors for development of PPC [OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05; OR:6.4, 95% CI (3.14-13.1) p<0.05].
Conclusion: The clinicians should be aware of PPCs especially in patients who were ≥ 65 years, had ASA≥3 and hypoalbuminemia (<3g/dl).
Kardiyotorasik dışı cerrahilerde postoperatif pulmoner komplikasyonlar
Özet
Amaç:Postoperatif pulmoner komplikasyonlar (PPK) önemli mortalite ve morbidite sebebidir. Çalışmamızın amacı ortopedi ve genel cerrahi operasyonlarından sonra gelişen PPK sıklığını ve risk faktörlerini belirlemektir.
Gereç ve Yöntem:Genel cerrahi, ortopedi ve travmatoloji kliniklerinde opere edilen haslar retrospektif olarak değerlendirildi.
Bulgular: Ortalama yaşı 59.43±18.77 yıl olan 683 hasta çalışmaya alındı.PPK %10.3 idi. Pnömöni (%6.3) en sık görülen PPK olarak tespit edildi.PPK sıklığı 65 yaş ve üs-tünde altında göre belirgin olarak yüksek saptandı. (18.2% vs 4.4%) (p<0.001).Acil cerrahi operasyonlarda elektif operasyonlara göre daha sık tespit edildi (24.1% vs 8%) (p<0.001).Operasyon süresinine göre (30 dk-1 st,1-2 st,2-3 st,4 st, >4st) PPK gelişim oranı sırasıyla %2.8,%9.5,%25,%75 ve %100 olarak bulundu (p<0.001). Çok değiş-kenli logiistik regresyon analizine göre ASA≥3, hipoalbunemi (<3g/dl) ve 65 yaş üstü PPK gelişiminde bağımsız risk faktörü olarak saptandı [OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05; OR:6.4, 95% CI (3.14-13.1) p<0.05].
Sonuç:ASA≥3, hipoalbunemi (<3g/dl) ve 65 yaş üzerinde klinisyenler PPK açısından dikkatli olmalıdır.

Anahtar Kelimeler

PPK, cerrahi, mortalite

Postoperative pulmonary complications in noncardiothoracic surgery

Öz

Purpose: Postoperative pulmonary complications (PPCs) are a major cause of mortality and morbidity. The
aim of this study is to evaluate frequencies and determine risk factors of PPCs which developed subsequent to
general surgery and orthopedic surgery in a tertiary university hospital.
Materials-methods: Patients who were operated in Departments of General Surgery and Orthopedics and
Traumatology were retrospectively included to the study.
Results: 683 patients with a mean age of 59.43±18.77 years were included in the study. The ratio of PPC was
10.3%. Most frequent PPC was found to be pneumonia (6.3%). The prevelance of PPC was significantly higher
in patients ≥65 years than who were <65 years old (18.2% vs 4.4%) (p<0.001). PPC was more frequent in
patients who undergone urgent surgery than those who undergone elective surgery (24.1% vs 8%) (p<0.001).
The rates of development of PPC according to the duration of operation (30 min-1 h, 1-2 h, 2-3 h, 3-4 h, >4
h) were respectively as follows 2.8%, 9.5%, 25%, 75% and 100% (p<0.001). Multivariable logistic regression
analysis showed that being ≥65 years, having ASA≥3 and hypoalbuminemia (<3g/dl) were independent risk
factors for development of PPC (OR:2.45, 95% CI (1.14-5.25) p<0.05; OR: 44.5, 95% CI (5.13-386.1) p<0.05;
OR:6.4, 95% CI (3.14-13.1) p<0.05).
Conclusion: The clinicians should be aware of PPCs especially in patients who were ≥65 years, had ASA≥3
and hypoalbuminemia (<3g/dl).

Anahtar Kelimeler

PPCs, surgery, mortality

Kaynakça

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