Variaveis pre-operatorias preditivas de risco para complicações pulmonares no pos-operatorio imediato de cirurgias de torax e abdomen alto

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

To identifY risk variables leading to early postoperative puImonary complications (POPC) in thoracic and upper abdominal surgery. 297 patients undergoing elective surgery were c1assified as low, moderate and high risk for POPC using the PORT scale, as proposed by Torrington &Henderson (1988). The patients were followed for 72 hours afier the operation. POPC were defined as atelectasis, pneumonia, tracheobronchitis, wheezing, prolonged intubation and for prolonged mechanical ventilation. Univariate ana1ysis was applied to study these independent variables: type of surgery, age; nutricional status (BMI), respiratory disease, smoking habit, spirometry, ASA scale and surgical time. Multivariate logistic regression ana1ysis was performed in order to evaluate the relationship between independent and dependent (POPC) variables. The of incidence POPC was 12.1%. According to the results of multivariate logistic regression ana1ysis the variables increasing the chance of POPC were cough with yellow mucus (OR= 3.8), thoracic surgery ( OR=2.9) compared to abdominal surgery, BMI (OR=1.13), duration of smoking habits (OR=1.03) and prolonged duration of surgery (OR=1.007). In the thoracic surgery group, multivariate logistic regression ana1ysis showed that wheezing (OR=6.2), BMI (OR=1.15), smoking for a long time (OR= 1.04) and prolonged duration of surgery ( OR= 1.007) were related to POPC. ASA scale did not show. statistic significance and PORT scale showed a 4 - fold increased risk in the mode;rate group and a 18 - fold increase in the high risk group indicated the need for a multiprofissional team included a physiotherapist in the preoperative care of those patients. The variables that increased the chance for POPC in thoracic and upper abdominal surgery were: cough with yellow mucus, thoracic surgery, decreased BMI, duration of smoking habits and duration of surgery. In the thoracic surgery group the significant variables were wheezing, decreased BMI, duration of smoking and duration of surgery. Key words: Surgery; Physical therapy; Postoperative complications

ASSUNTO(S)

fisioterapia cirurgia

Documentos Relacionados