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Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients

Title
Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients
Author
이현
Keywords
chronic obstructive pulmonary disease; complications; spirometry; surgery
Issue Date
2017-01
Publisher
WILEY
Citation
RESPIROLOGY, v. 22, no. 5, page. 935-941
Abstract
Background and objectiveThe association between airflow limitation severity and post-operative pulmonary complications (PPCs) among COPD patients undergoing extra-pulmonary surgery is unknown. We evaluated the association between forced expiratory volume in 1s (FEV1 ) and PPC in COPD patients undergoing extra-pulmonary surgery.MethodsUsing prospective cohort of PPC evaluation for extra-pulmonary surgery, we identified 694 COPD patients who conducted PPC evaluation before extra-pulmonary surgery between March 2014 and January 2015 at a tertiary hospital, Seoul, Korea.ResultsThe overall incidence of PPC was 24.4%. The incidence of PPC in quintiles 1-5 of FEV1 (% predicted) was 31.4, 25.8, 23.7, 21.6 and 19.7%, respectively (P for trend: 0.019). In fully adjusted multivariable models, the relative risks (RRs, 95% CI) for PPC comparing participants in quintiles 1-4 of FEV1 (% predicted) with those in quintile 5 were 1.69 (1.03-2.79), 1.41 (0.83-2.37), 1.26 (0.75-2.11) and 1.30 (0.76-2.22), respectively (P for trend: 0.046). The association of severe airflow limitation with respiratory failure and post-operative exacerbations was stronger in participants who did not use bronchodilators compared with those who did.ConclusionWe found a progressive and significant relationship between severity of airflow limitation and the incidence of PPC in COPD patients undergoing extra-pulmonary surgery. Furthermore, perioperative bronchodilator use was associated with a reduced risk of respiratory failure and post-operative exacerbations in patients with severe airflow limitation.
URI
https://onlinelibrary.wiley.com/doi/full/10.1111/resp.12988http://repository.hanyang.ac.kr/handle/20.500.11754/105643
ISSN
1323-7799; 1440-1843
DOI
10.1111/resp.12988
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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