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Volume 2023, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Postoperative pulmonary complications (PPC) include any complication that affects the respiratory system after anesthesia and surgery and are a significant cause of postoperative mortality and morbidity.

Objectives: To describe the risk factors for immediate postoperative pulmonary complications after appendectomy under general anesthesia and to determine if rapid sequence induction decreases the risk.

Design and Setting: A retrospective analysis of perioperative medical records of patients who underwent appendectomy under general anesthesia over a year, from January 1st, 2014, to December 31st, 2014, at Hamad General Hospital, Doha, Qatar, was done.

Results: Of the 1005 patients who met the inclusion criteria, 27 (3.7%) had PPC. The incidence of PPC had a significant positive association with diabetes mellitus (DM), bronchial asthma (BA), number of intubation attempts, laparoscopic approach, and longer surgeries (>2 h). Hypertension, recent or ongoing upper respiratory tract infections, and smoking were not associated with an increased risk of PPC. Non-rapid sequence intubation (RSI) was not associated with an increased risk of PPC compared with RSI.

Conclusions: The incidence of immediate PPC in ASA 1 and 2 appendectomy patients aged between 15 and 50 is significant. There is an increased risk among asthmatics, diabetics, and those with difficult airways. The RSI technique does not offer protection.

© 2023 Kumar, Ayasa, Krishnadas, Chandra, Al-Mustafa, Praveen, Sinha, Sasi, licensee HBKU Press.
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2023-09-14
2024-07-27
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References

  1. Selassie HG, Selassie HT, Ashebir D. Pattern and outcome of acute appendicitis: Observational prospective study from a teaching hospital, Addis Ababa, Ethiopia. Open Access Emerg Med. 2021; 13::265–71. doi:10.2147/OAEM.S315228.
     [Google Scholar]
  2. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The global incidence of appendicitis: A systematic review of population-based studies. Ann Surg. 2017; 266:(2):237–41. doi:10.1097/SLA.0000000000002188.
     [Google Scholar]
  3. Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth. 2017; 118:(3):317–34. doi:10.1093/bja/aex002.
     [Google Scholar]
  4. Numata T, Nakayama K, Fujii S, Yumino Y, Saito N, Yoshida M, et al. Risk factors of postoperative pulmonary complications in patients with asthma and COPD. BMC Pulm Med. 2018; 18:(1):4. doi:10.1186/s12890-017-0570-8.
     [Google Scholar]
  5. Im Y, Park HY, Shin S, Shin SH, Lee H, Ahn JH, et al. Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early-stage lung cancer. Respir Res. 2019; 20:(1):136. doi:10.1186/s12931-019-1087-x.
     [Google Scholar]
  6. Ufoaroh CU, Ele PU, Anyabolu AE, Enemuo EH, Emegoakor CD, Okoli CC, et al. Pre-operative pulmonary assessment and risk factors for postoperative pulmonary complications in elective abdominal surgery in Nigeria. Afr Health Sci. 2019; 19:(1):1745–56. doi:10.4314/ahs.v19i1.51.
     [Google Scholar]
  7. Sun J, Wei G, Hu L, Liu C, Ding Z. Perioperative pulmonary aspiration and regurgitation without aspiration in adults: A retrospective observational study of 166,491 anesthesia records. Ann Palliat Med. 2021; 10:(4):4037–46. doi:10.21037/apm-20-2382.
     [Google Scholar]
  8. Istvan J, Belliveau M, Donati F. Rapid sequence induction for appendectomies: A retrospective case-review analysis. Can J Anaesth. 2010 Apr; 57:(4):330–6. doi:10.1007/s12630-009-9260-1.
     [Google Scholar]
  9. Jammer I, Wickboldt N, Sander M, Smith A, Schultz MJ, Pelosi P, et al.; European Society of Anaesthesiology; European Society of Intensive Care Medicine. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: A statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015; 32:(2):88–105. doi:10.1097/EJA.0000000000000118.
     [Google Scholar]
  10. Wang J, Chen K, Li X, Jin X, An P, Fang Y, et al. Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery. Medicine (Baltimore). 2019; 98:(14):e15089. doi:10.1097/MD.0000000000015089.
     [Google Scholar]
  11. Yang CK, Teng A, Lee DY, Rose K. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis. J Surg Res. 2015 Oct; 198:(2):441–9. doi:10.1016/j.jss.2015.03.028.
     [Google Scholar]
  12. Jeong B-H, Shin B, Eom JS, Yoo H, Song W, Han S, et al. Development of a prediction rule for estimating postoperative pulmonary complications. PLoS One. 2014 Dec 1; 9:(12):e113656. doi:10.1371/journal.pone.0113656.
     [Google Scholar]
  13. Fernandez-Bustamante A, Frendl G, Sprung J, Kor DJ, Subramaniam B, Ruiz RM, et al. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: A multicenter study by the perioperative research network investigators. JAMA Surg. 2017; 152:(2):157–66. doi:10.1001/jamasurg.2016.4065.
     [Google Scholar]
  14. Chaabna K, Cheema S, Abraham A, Alrouh H, Mamtani R. Adult mortality trends in Qatar, 1989-2015: National population versus migrants. PLoS One. 2018 Sep 25; 13:(9):e0203996. doi:10.1371/journal.pone.0203996.
     [Google Scholar]
  15. Alah MA, Abdeen S, Kehyayan V, Bougmiza I. The impact of changes in work arrangements during COVID-19 pandemic on the lifestyle of Qatar’s working population. J Occup Environ Med. 2022 Feb 1; 64:(2):e53–9. doi:10.1097/JOM.0000000000002443.
     [Google Scholar]
  16. Li G, Freundlich RE, Gupta RK, Hayhurst CJ, Le CH, Martin BJ, et al. Postoperative pulmonary complications’ association with sugammadex versus neostigmine: A retrospective registry analysis. Anesthesiology. 2021; 134:(6):862–73. doi:10.1097/ALN.0000000000003735.
     [Google Scholar]
  17. Davies OJ, Husain T, Stephens RCM. Postoperative pulmonary complications following non-cardiothoracic surgery. BJA Educ. 2017 Sep; 17:(9):295–300. doi:10.1093/bjaed/mkx012.
     [Google Scholar]
  18. Lauruschkat AH, Arnrich B, Albert AA, Walter JA, Amann B, Rosendahl UP, et al. Diabetes mellitus as a risk factor for pulmonary complications after coronary bypass surgery. J Thorac Cardiovasc Surg. 2008 May; 135:(5):1047–53. doi:10.1016/j.jtcvs.2007.07.066.
     [Google Scholar]
  19. Lawlor DA, Ebrahim S, Smith GD. Associations of measures of lung function with insulin resistance and Type 2 diabetes: Findings from the British Women’s Heart and Health Study. Diabetologia. 2004; 47:(2):195–203. doi:10.1007/s00125-003-1310-6.
     [Google Scholar]
  20. Jeganathan V, Knight S, Bricknell M, Ridgers A, Wong R, Brazzale DJ, et al. Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery. PLoS One. 2022; 17:(3):e0266052. doi:10.1371/journal.pone.0266052.
     [Google Scholar]
  21. Gupta S, Fernandes RJ, Rao JS, Dhanpal R. Perioperative risk factors for pulmonary complications after non-cardiac surgery. J Anaesthesiol Clin Pharmacol. 2020; 36:(1):88–93. doi:10.4103/joacp.JOACP_54_19.
     [Google Scholar]
  22. Mazo V, Sabaté S, Canet J, Gallart L, de Abreu MG, Belda J, et al. Prospective external validation of a predictive score for postoperative pulmonary complications. Anesthesiology. 2014; 121:(2):219–31. doi:10.1097/ALN.0000000000000334.
     [Google Scholar]
  23. Gupta H, Gupta PK, Schuller D, Fang X, Miller WJ, Modrykamien A, et al. Development and validation of a risk calculator for predicting postoperative pneumonia. Mayo Clin Proc. 2013; 88:(11):1241–9. doi:10.1016/j.mayocp.2013.06.027.
     [Google Scholar]
  24. Kodra N, Shpata V, Ohri I. Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery. Open Access Maced J Med Sci. 2016; 4:(2):259–63. doi:10.3889/oamjms.2016.059.
     [Google Scholar]
  25. Dubé B-P, Dres M. Diaphragm dysfunction: Diagnostic approaches and management strategies. J Clin Med. 2016; 5:(12):113. doi:10.3390/jcm5120113.
     [Google Scholar]
  26. Biondi A, Di Stefano C, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: A retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg. 2016; 11:(1):44. doi:10.1186/s13017-016-0102-5.
     [Google Scholar]
  27. Jaschinski T, Mosch CG, Eikermann M, Neugebauer EAM, Sauerland S. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2018; 2018:(11):CD001546. doi:10.1002/14651858.
     [Google Scholar]
/content/journals/10.5339/qmj.2023.20
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Factors associated with immediate postoperative pulmonary complications after Appendectomies under general anesthesia: A retrospective analysis
Qatar Medical Journal 2023, 20 (2023); https://doi.org/10.5339/qmj.2023.20
/content/journals/10.5339/qmj.2023.20
/content/journals/10.5339/qmj.2023.20
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  • Article Type: Research Article
Keyword(s): Appendectomy, Appendicitis, Complications, General Anesthesia and Post-operative

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