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Pre-operative pulmonary assessment and risk factors for post-operative pulmonary complications in elective abdominal surgery in Nigeria


Chinyelu Uchenna Ufoaroh
Prince Udegbunam Ele
Arthur Ebelenna Anyabolu
Emeka Hyacinth Enemuo
Chiemelu Dickson Emegoakor
Chinedu Christian Okoli
Eric Okechukwu Umeh
Ernest Ndukaife Anyabolu

Abstract

Background and Objectives: Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgerypatients in Nigeria.

Methodology: This was a prospective study in patients booked for surgery in 2014. Biodata, medical his tory, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined.

Results: The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p< 0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05).

Conclusion: The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnor- mally low percentage predicted FEV1 and FVC were associated with PPCs.

Keywords: Post-operative pulmonary complications, pre-operative assessment, risk factors, cough, shortness of breath, consol- idation, pneumonia, elective abdominal surgeries, Nnewi, Nigeria.