Asymptomatic Patients with Airflow Limitation are at Higher Risk of Postoperative Pulmonary Complications After Lung Surgeries: An Ambispective Cohort Study

Abstract

Yang Wang,1 Xiangyu Yin,2 Mengshuang Xie,3 Qin Wang,1 Wei Wang,4 Wenbo Yi,1 Jingui Yu1 1Department of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; 2Department of Joint Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China; 3Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; 4Department of Pulmonary and Critical Care Medicine, School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, ChinaCorrespondence: Jingui YuDepartment of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhua West Road, Jinan, Shandong, 250012, ChinaTel [phone]Fax [phone]Email [email protected]: With the use of pulmonary function tests (PFTs) as a preoperative examination, it is not rare to screen out airflow limitation (AFL) in asymptomatic patients undergoing lung surgeries. This study aims to elucidate whether there is a difference in the prevalence and prognosis of postoperative pulmonary complications (PPCs) between asymptomatic patients with newly diagnosed AFL and the normal population undergoing lung surgeries.Patients and Methods: The medical records of asymptomatic patients undergoing lung surgeries who were spirometrically diagnosed with AFL between January and October 2017 were collected in Qilu hospital. These patients were subsequently followed up until February 2021. The diagnosis of PPCs was based on a recommended consensus definition. The incidence of PPCs between the newly diagnosed AFL group and the normal group was compared and a propensity score-matched analysis (PSM) was performed. The survival analysis was performed to investigate the long-term prognosis of the two groups.Results: Overall, 535 asymptomatic subjects were recruited and 126 subjects (11.4%) were spirometrically diagnosed as AFL. The incidence of PPCs was significantly higher in the newly diagnosed AFL group than in the normal population (28.6%VS 14.4%, P 0.05).Conclusion: Asymptomatic patients with AFL are at higher risk of PPCs than the general population after lung surgeries, along with an increase in ICU admissions and 90-day hospital readmissions secondary to PPCs. Although these patients tended to report worse current conditions, they were similar in the in-hospital, 90-day and overall mortality during the follow-up.Keywords: pulmonary function tests, newly diagnosed airflow limitation, propensity score-matched analysis, postoperative outcomes

Keywords

• pulmonary function tests
• newly diagnosed airflow limitation
• propensity score-matched analysis
• postoperative outcomes