Risk factors of postoperative pulmonary complications in bronchial asthma and COPD patients

Background The postoperative pulmonary complication (PPC) is an important surgical risk as common as the cardiac one, containing atelectasis, pneumonia, and respiratory failure. Objective The purpose of this study is to evaluate the risk factors for PPC in the patients with major respiratory underlying diseases such as bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) in our university hospital. Methods Totally 10699 patients were surgically treated in our university hospital from April to December in 2014. Among them, there were 68 COPD patients and 181 BA ones studied here. Eight of 68 COPD patients (11.8%) had PPC with 6 consolidations and 2 consolidations + respiratory failures, whereas 16 of 181 BA patients (8.8%) had PPC with 14 asthma attacks and 2 consolidations. We retrospectively evaluated physiological background, pulmonary function, duration of surgery, and perioperative specific treatment for pulmonary diseases to analyze the risk for PPC in these patients. Results In the BA patients, smoking index> 20 pack-year was significantly associated with PPC [OR (95%CI) = 11.7(2.6-52.1), P= 0.0013]. In the COPD patients, induction of COPD specific treatment and duration of surgery >300minites were significantly associated with PPC [OR (95%CI) = 0.09(0.01-0.63), P= 0.016; OR (95%CI) = 9.5(1.4-65.3), P= 0.022, respectively] Conclusions To prevent PPC, smoking cessation in BA and induction of specific treatment and shortening of surgery time in COPD were critically important.