Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery

Autores

  • PereiraEanes Delgado Barros Pereira Federal University of Ceará
  • Ana Luisa Godoy Fernandes Federal University of São Paulo
  • Meide da Silva Anção Federal University of São Paulo
  • Clóvis de Araújo Peres University of São Paulo
  • Álvaro Nagib Atallah Federal University of São Paulo
  • Sonia Maria Faresin Federal University of São Paulo

Palavras-chave:

abdominal surgery, risk factor, morbidity

Resumo

OBJETIVO: Avaliar associações entre a presença de variáveis pré-operatórias e a ocorrência de complicações pulmonares no pós-operatório de cirurgia abdominal alta eletiva. TIPO DE ESTUDO: Experimentação clínica em perspectiva. PACIENTES: 408 pacientes foram avaliados prospectivamente no pré-operatório e seguidos no pós-operatório para avaliação de complicações pulmonares. VARIÁVEIS MEDIDAS: Características dos pacientes: historia clínica e exame físico, doenças associadas, tabagismo, e tempo cirúrgico. Foi realizado espirometria no período pré-operatório em 247 pacientes. RESULTADOS : A incidência de complicações pulmonares no pós-operatório foi 14%. Na análise univariada comportaram-se como fatores de risco para ocorrência de complicações pulmonares no pós-operatório: idade acima de 50 anos, tabagismo, a presença de doença pulmonar crônica ou sintomas respiratórios no momento da avaliação, tempo cirúrgico maior que 210 minutos e a coexistência de doença clínica (p< 0,04). Na análise de regressão logística comportaram-se como fatores de risco somente a presença de doença pulmonar crônica, tempo cirúrgico maior que 210 minutos e coexistência de doença clínica associada. (p< 0,009). CONCLUSÃO: Existem três fatores de risco clínicos para complicações pulmonares no pós-operatório de cirurgia abdominal alta: doença pulmonar crônica, tempo cirúrgico maior que 210 minutos e coexistência de doença clínica. Os pacientes que apresentam estes fatores de risco têm três vezes mais chance de complicar do ponto de vista pulmonar no pós-operatório quando comparados aqueles que não apresentam estes fatores de risco (p< 0,001). A espirometria está indicada quando não existe certeza quanto ao quadro pulmonar do paciente.

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Biografia do Autor

PereiraEanes Delgado Barros Pereira, Federal University of Ceará

MD, PhD, Associate Professor, Department of Medicine, Pulmonary Division, Federal University of Ceará - Brazil

Ana Luisa Godoy Fernandes, Federal University of São Paulo

MD, PhD, Associate Professor, Department of Medicine, Pulmonary Division, Federal University of São Paulo - Brazil

Meide da Silva Anção, Federal University of São Paulo

MD, PhD, Associate Professor, Department of Medicine, Division of Nephrology, Federal University of São Paulo - Brazil

Clóvis de Araújo Peres, University of São Paulo

PhD, Professor of Statistics of University of São Paulo

Álvaro Nagib Atallah, Federal University of São Paulo

MD, PhD, Head of Internal Medicine Division of Federal University of São Paulo - Brazil

Sonia Maria Faresin, Federal University of São Paulo

MD, PhD, Physician of Department of Medicine, Pulmonary Division, Federal University of São Paulo- Brazil. Chief of Preoperative Respiratory Care of São Paulo Hospital

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Publicado

1999-07-07

Como Citar

1.
Pereira PDB, Fernandes ALG, Anção M da S, Peres C de A, Atallah Álvaro N, Faresin SM. Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery. Sao Paulo Med J [Internet]. 7º de julho de 1999 [citado 15º de março de 2025];117(4):151-60. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/2550

Edição

v. 117 n. 4 (1999)

Seção

Artigo Original

Licença

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.