Facteurs de risque périopératoires des patients atteints de fibrose pulmonaire idiopathique: une étude de cohorte historique

Translated title of the contribution: Perioperative risk factors in patients with idiopathic pulmonary fibrosis: a historical cohort study

Brittany J. McDowell, Kunal Karamchandani, Erik B. Lehman, Matthew J. Conboy, Zyad J. Carr

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: Perioperative complications of patients with idiopathic pulmonary fibrosis (IPF) are not well described. The aim of this study was to identify risk factors associated with adverse postoperative outcomes in IPF patients. Methods: We performed a single-centre historical cohort study of adult patients with IPF who underwent surgery between 2008 and 2018. We analyzed the prognostic utility of select perioperative factors for postoperative acute exacerbation of IPF (AE-IPF), acute respiratory worsening (ARW), pneumonia, and 30-day and one-year mortality using univariable and multivariable regression analyses. To adjust for multiple interactions, the false discovery rate (Q value) was utilized to appropriately adjust P values and a Q value < 0.05 was considered to be significant. Results: Two hundred and eighty-two patients were identified. After excluding emergency cases and bronchoscopies performed for active pneumonia, 14.2% of the cohort developed ARW that persisted > 24 hr after surgery, 5.0% had AE-IPF, and 9.2% were diagnosed with postoperative pneumonia within 30 days of surgery. The 30-day mortality was 6.0% and the one-year mortality was 14.9%. Preoperative home oxygen use (relative risk [RR], 2.70; 95% confidence interval [CI], 1.50 to 4.86; P < 0.001) and increasing surgical time (per 60 min) (RR, 1.03; 95% CI, 1.02 to 1.05; P < 0.001) were identified as independent risk factors for postoperative ARW. Conclusions: In IPF patients, preoperative home oxygen requirement and increasing surgical time showed a strong relationship with postoperative ARW and may be useful markers for perioperative risk stratification.

Translated title of the contributionPerioperative risk factors in patients with idiopathic pulmonary fibrosis: a historical cohort study
Original languageFrench
Pages (from-to)81-91
Number of pages11
JournalCanadian Journal of Anesthesia
Volume68
Issue number1
DOIs
StatePublished - Jan 2021
Externally publishedYes

Keywords

  • anesthesia
  • anesthesiology
  • idiopathic pulmonary fibrosis
  • interstitial lung disease
  • perioperative

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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