Respiratory Complications After Colorectal Surgery: Avoidable or Fate?

Details

Serval ID
serval:BIB_801EF01ED5EF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Respiratory Complications After Colorectal Surgery: Avoidable or Fate?
Journal
World journal of surgery
Author(s)
Jurt J., Hübner M., Pache B., Hahnloser D., Demartines N., Grass F.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
09/2018
Peer-reviewed
Oui
Volume
42
Number
9
Pages
2708-2714
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The prevention of post-operative pulmonary complications (PPC) is targeted by several enhanced recovery (ERAS) items including early mobilisation, prevention of fluid overload and omission of routine nasogastric tubes. The aim of the present study was to assess the impact of ERAS on PPC.
This was a retrospective analysis of an institutional database including consecutive colorectal ERAS procedures from May 2011 until May 2017. Multiple logistic regressions were performed to identify risk factors for PPC among demographic, surgical characteristics and items related to the ERAS protocol.
In total, 1298 patients were included; among them 120 (9.2%) had one or more PPC. Multivariable analysis retained minimally invasive surgery [odds ratio (OR) 0.26; 95% confidence interval (CI) 0.15-0.46] and compliance to the ERAS protocol of ≥ 70% (OR 0.53; CI 0.30-0.94) as protective factors. Emergency surgery (OR 2.70; CI 1.20-6.01), blood loss of ≥ 200 mL (OR 2.06; CI 1.20-3.53) and ASA score of ≥ 3 (OR 2.00; CI 1.12-3.57) were independent risk factors. Median length of hospital stay was significantly longer in patients who experienced respiratory complications (21 [4-183] vs. 6 [1-95] days, p ≤ 0.001).
Minimally invasive surgery and high compliance with the ERAS protocol can help to prevent PPC.
Keywords
Aged, Clinical Protocols, Colectomy/adverse effects, Early Ambulation, Female, Fluid Therapy/adverse effects, Guideline Adherence, Humans, Intubation, Gastrointestinal/adverse effects, Length of Stay, Male, Middle Aged, Minimally Invasive Surgical Procedures, Patient Compliance, Perioperative Care, Proctectomy/adverse effects, Recovery of Function, Respiration Disorders/etiology, Respiration Disorders/prevention & control, Retrospective Studies, Risk Factors
Pubmed
Web of science
Create date
27/08/2018 17:56
Last modification date
20/08/2019 15:40
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