TY - JOUR
T1 - Impact of COPD on postoperative outcomes
T2 - Results from a national database
AU - Gupta, Himani
AU - Ramanan, Bala
AU - Gupta, Prateek K.
AU - Fang, Xiang
AU - Polich, Ann
AU - Modrykamien, Ariel
AU - Schuller, Dan
AU - Morrow, Lee E.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2013/6
Y1 - 2013/6
N2 - Background: Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. Methods: Patients with COPD who underwent surgery were identified from the National Surgical Quality Improvement Program database (2007-2008). Univariate and multivariate analyses were performed on this multicenter, prospective data set (N = 468,795). Results: COPD was present in 22,576 patients (4.82%). These patients were more likely to be older, men, white, smokers, and taking corticosteroids and had a lower BMI (P<.0001 for each). Median length of stay was 4 days for patients with COPD vs 1 day in those without COPD (P<.0001). Thirty-day morbidity rates were 25.8% and 10.2% for patients with and without COPD, respectively (P<.0001). Thirty-day death rates were 6.7% and 1.4% for patients with and without COPD, respectively (P<.0001). After controlling for > 50 comorbidities through logistic regression modeling, COPD was independently associated with higher postoperative morbidity (OR, 1.35; 95% CI, 1.30-1.40; P<.0001) and mortality (OR, 1.29; 95% CI, 1.19-1.39; P<.0001). Multivariate analyses with each individual postoperative complication as the outcome of interest showed that COPD was associated with increased risk for postoperative pneumonia, respiratory failure, myocardial infarction, cardiac arrest, sepsis, return to the operating room, and renal insufficiency or failure (P<.05 for each). Conclusions: COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.
AB - Background: Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. Methods: Patients with COPD who underwent surgery were identified from the National Surgical Quality Improvement Program database (2007-2008). Univariate and multivariate analyses were performed on this multicenter, prospective data set (N = 468,795). Results: COPD was present in 22,576 patients (4.82%). These patients were more likely to be older, men, white, smokers, and taking corticosteroids and had a lower BMI (P<.0001 for each). Median length of stay was 4 days for patients with COPD vs 1 day in those without COPD (P<.0001). Thirty-day morbidity rates were 25.8% and 10.2% for patients with and without COPD, respectively (P<.0001). Thirty-day death rates were 6.7% and 1.4% for patients with and without COPD, respectively (P<.0001). After controlling for > 50 comorbidities through logistic regression modeling, COPD was independently associated with higher postoperative morbidity (OR, 1.35; 95% CI, 1.30-1.40; P<.0001) and mortality (OR, 1.29; 95% CI, 1.19-1.39; P<.0001). Multivariate analyses with each individual postoperative complication as the outcome of interest showed that COPD was associated with increased risk for postoperative pneumonia, respiratory failure, myocardial infarction, cardiac arrest, sepsis, return to the operating room, and renal insufficiency or failure (P<.05 for each). Conclusions: COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.
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U2 - 10.1378/chest.12-1499
DO - 10.1378/chest.12-1499
M3 - Article
C2 - 23287892
AN - SCOPUS:84878528024
SN - 0012-3692
VL - 143
SP - 1599
EP - 1606
JO - Diseases of the chest
JF - Diseases of the chest
IS - 6
ER -