Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study
BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease.
METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality.
RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre- and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001).
CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery.
| Errataetall: |
CommentIn: Minerva Anestesiol. 2023 Nov;89(11):957-959. - PMID 37921197 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:89 |
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| Enthalten in: |
Minerva anestesiologica - 89(2023), 11 vom: 01. Nov., Seite 964-976 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Piccioni, Federico [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 06.11.2023 Date Revised 25.01.2024 published: Print-Electronic CommentIn: Minerva Anestesiol. 2023 Nov;89(11):957-959. - PMID 37921197 Citation Status MEDLINE |
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| doi: |
10.23736/S0375-9393.23.17382-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Piccioni, Federico |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Postoperative pulmonary complications and mortality after major abdominal surgery. An observational multicenter prospective study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 06.11.2023 | ||
| 500 | |a Date Revised 25.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Minerva Anestesiol. 2023 Nov;89(11):957-959. - PMID 37921197 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Postoperative pulmonary complications (PPCs) significantly contribute to postoperative morbidity and mortality. We conducted a study to determine the incidence of PPCs after major elective abdominal surgery and their association with early and 1-year mortality in patient without pre-existing respiratory disease | ||
| 520 | |a METHODS: We conducted a multicenter observational prospective clinical study in 40 Italian centers. 1542 patients undergoing elective major abdominal surgery were recruited in a time period of 14 days and clinically managed according to local protocol. The primary outcome was to determine the incidence of PPCs. Further, we aimed to identify independent predictors for PPCs and examine the association between PPCs and mortality | ||
| 520 | |a RESULTS: PPCs occurred in 12.6% (95% CI 11.1-14.4%) of patients with significant differences among general (18.3%, 95% CI 15.7-21.0%), gynecological (3.7%, 95% CI 2.1-6.0%) and urological surgery (9.0%, 95% CI 6.0-12.8%). PPCs development was associated with known pre- and intraoperative risk factors. Patients who developed PPCs had longer length of hospital stay, higher risk of 30-days hospital readmission, and increased in-hospital and one-year mortality (OR 3.078, 95% CI 1.825-5.191; P<0.001) | ||
| 520 | |a CONCLUSIONS: The incidence of PPCs in patients without pre-existing respiratory disease undergoing elective abdominal surgery is high and associated with worse clinical outcome at one year after surgery. General surgery is associated with higher incidence of PPCs and mortality compared to gynecological and urological surgery | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Spagnesi, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Pelosi, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Bignami, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Guarnieri, Marcello |e verfasserin |4 aut | |
| 700 | 1 | |a Fumagalli, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Polati, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Schweiger, Vittorio |e verfasserin |4 aut | |
| 700 | 1 | |a Comi, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a D'Andrea, Rocco |e verfasserin |4 aut | |
| 700 | 1 | |a DI Marco, Pierangelo |e verfasserin |4 aut | |
| 700 | 1 | |a Spadaro, Savino |e verfasserin |4 aut | |
| 700 | 1 | |a Antonelli, Serena |e verfasserin |4 aut | |
| 700 | 1 | |a Sollazzi, Liliana |e verfasserin |4 aut | |
| 700 | 1 | |a Mirabella, Lucia |e verfasserin |4 aut | |
| 700 | 1 | |a Schiavoni, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Laici, Cristiana |e verfasserin |4 aut | |
| 700 | 1 | |a Marelli, Jlenia A |e verfasserin |4 aut | |
| 700 | 1 | |a Fabiani, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Ball, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Roasio, Agostino |e verfasserin |4 aut | |
| 700 | 1 | |a Servillo, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Franchi, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Murino, Patrizia |e verfasserin |4 aut | |
| 700 | 1 | |a Irone, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Parrini, Vieri |e verfasserin |4 aut | |
| 700 | 1 | |a DE Cosmo, Germano |e verfasserin |4 aut | |
| 700 | 1 | |a Cornara, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Ruberto, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Pasta, Gilda |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Lorenzo |e verfasserin |4 aut | |
| 700 | 1 | |a Greco, Massimiliano |e verfasserin |4 aut | |
| 700 | 1 | |a Cecconi, Maurizio |e verfasserin |4 aut | |
| 700 | 1 | |a Della Rocca, Giorgio |e verfasserin |4 aut | |
| 700 | 0 | |a PPCs Investigators Group |e verfasserin |4 aut | |
| 700 | 1 | |a Aceto, Paola |e investigator |4 oth | |
| 700 | 1 | |a Adrario, Erica |e investigator |4 oth | |
| 700 | 1 | |a Artico, Carlo |e investigator |4 oth | |
| 700 | 1 | |a Baravelli, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Barbariol, Federico |e investigator |4 oth | |
| 700 | 1 | |a Bettonte, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Bianchin, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Bifulco, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Brienza, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Buttazzoni, Mattia |e investigator |4 oth | |
| 700 | 1 | |a Cataldo, Rita |e investigator |4 oth | |
| 700 | 1 | |a Copetti, Elisa |e investigator |4 oth | |
| 700 | 1 | |a Cornara, Pietro |e investigator |4 oth | |
| 700 | 1 | |a Cuomo, Arturo |e investigator |4 oth | |
| 700 | 1 | |a DE Negri, Pasquale |e investigator |4 oth | |
| 700 | 1 | |a Del Vicario, Miryam |e investigator |4 oth | |
| 700 | 1 | |a Domini, Michele |e investigator |4 oth | |
| 700 | 1 | |a Dusi, Federica |e investigator |4 oth | |
| 700 | 1 | |a Faliva, Alessio |e investigator |4 oth | |
| 700 | 1 | |a Forfori, Francesco |e investigator |4 oth | |
| 700 | 1 | |a Franco, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Gianni, Stefano |e investigator |4 oth | |
| 700 | 1 | |a Guasti, Guido |e investigator |4 oth | |
| 700 | 1 | |a Iacobone, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Lo Martire, Nazzareno |e investigator |4 oth | |
| 700 | 1 | |a Lombardo, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Lorini, Ferdinando L |e investigator |4 oth | |
| 700 | 1 | |a Maucione, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Mazzoli, Carlo A |e investigator |4 oth | |
| 700 | 1 | |a Migliavacca, Silvana |e investigator |4 oth | |
| 700 | 1 | |a Miglio, Fabrizio |e investigator |4 oth | |
| 700 | 1 | |a Molin, Alexandre |e investigator |4 oth | |
| 700 | 1 | |a Nese, Antonella |e investigator |4 oth | |
| 700 | 1 | |a Oggiano, Marco |e investigator |4 oth | |
| 700 | 1 | |a Papagni, Gabriele |e investigator |4 oth | |
| 700 | 1 | |a Pecchia, Monica |e investigator |4 oth | |
| 700 | 1 | |a Perilli, Valter |e investigator |4 oth | |
| 700 | 1 | |a Previtali, Paola |e investigator |4 oth | |
| 700 | 1 | |a Prizio, Guido |e investigator |4 oth | |
| 700 | 1 | |a Punzo, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Rainaldi, Maria P |e investigator |4 oth | |
| 700 | 1 | |a Rigillo, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Sacco, Teresa |e investigator |4 oth | |
| 700 | 1 | |a Santagata, Carmen |e investigator |4 oth | |
| 700 | 1 | |a Serena, Giovanni |e investigator |4 oth | |
| 700 | 1 | |a Siniscalchi, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Toninelli, Arturo |e investigator |4 oth | |
| 700 | 1 | |a Toretti, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Tullo, Livio |e investigator |4 oth | |
| 700 | 1 | |a Vargas, Maria |e investigator |4 oth | |
| 700 | 1 | |a Zanier, Chiara |e investigator |4 oth | |
| 700 | 1 | |a Zocca, Edoardo |e investigator |4 oth | |
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