Role of spirometric and arterial gas data in predicting pulmonary complications after abdominal surgery

The aim of this study was to evaluate the predictive value of preoperative spirometric and arterial gas data on severe pulmonary complications (PC) af ter elective abdominal surgery. We retrospectively studied 480 patients, 254 males and 226 females, mean (S D) age 63 (11) years, at risk for PC according to standardized criteria, wh o underwent laparotomy for resection of gallbladder for gallstones (44% of patients), resection of colon, rectum or stomach for malignant tumours (37% ), and other abdominal surgery (19%). The overall incidence of postoperative PC was 18%. In a logistic regression analysis adjusted for smoking habit and clinical history of chronic bronch itis, FEV1 < 61% of predicted [odds ratio (OR)=16.86, 95% confidence interv al (95%CI)=5.62-50.58] and PaO2<9.33 kPa (OR=6.42, 95%CI=2.48-16.61) were t he main determinants of PC. Ischaemic heart disease (OR=3.44, 95%CI=1.08-10 .93), operation for malignant tumours (OR=3.24, 95%CI=1.75-6.00) and age (O R=1.04, 95%CI=1.00-1.08) were also independent predictors of PC. Patients with moderate-to-severe airway obstruction combined with hypoxaemi a had a significant higher risk of PC in comparison with patients with a no rmal respiratory pattern. Taking into account age, type of operation, and c omorbidity, a preoperative respiratory functional assessment could be usefu l in identifying an increased risk of major PC in selected patients.