FACTORS ASSOCIATED WITH POSTOPERATIVE PULMONARY COMPLICATIONS IN PATIENTS WITH SEVERE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE
FACTORS ASSOCIATED WITH POSTOPERATIVE PULMONARY COMPLICATIONS IN PATIENTS WITH SEVERE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE
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DOI：
10.1097/00000539-199502000-00013
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发表时间：
1995-02-01
影响因子：
5.7
通讯作者：
BARKER, SJ
中科院分区：
文献类型：
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作者：
WONG, DH;WEBER, EC;BARKER, SJ
本研究的目的是确定严重慢性阻塞性肺疾病 (COPD)（1 秒用力呼气量 [FEV(1)] 小于或等于 1.2 L 和 FEV(1)/用力肺活量 (FVC) 2 小时患者不同术后肺部并发症 (PPC) 的发生率及其相关危险因素。我们研究患者的 2 年死亡率为 47%。我们通过分析潜在的术前和术后并发症，确定了每种 PPC 的具体危险因素。术中危险因素本身并不能预测严重 COPD 患者发生 PPC 的可能性。多重逻辑回归确定综合评分系统（例如 ASA 身体状况）是 PPC 的最佳术前预测因素，可能是因为它们包括肺部和非肺部因素。在术中，避免气管插管全身麻醉可能会降低术后支气管痉挛的风险。入住ICU。
The purpose of this study was to determine the incidence of different postoperative pulmonary complications (PPCs) and their associated risk factors in patients with severe chronic obstructive pulmonary disease (COPD) (forced expiratory volume in 1 s [FEV(1)] less than or equal to 1.2 L and FEV(1)/forced vital capacity (FVC) 2 h. Our study patients had a 47% 2-yr mortality rate. We determined specific risk factors for each PPC by analyzing potential preoperative and intraoperative risk factors. Pulmonary factors alone do not predict the likelihood of PPCs in severe COPD patients. Multiple logistic regression identified composite scoring systems, such as the ASA physical status, as the best preoperative predictors of PPCs, probably because they include both pulmonary and nonpulmonary factors. During the intraoperative period, avoiding general anesthesia with tracheal intubation may decrease the risk of postoperative bronchospasm. Shortening the duration of surgery and anesthesia may decrease the risk of prolonged ICU stay.