Background: One of the characteristics of chronic obstructive pulmonary disease (COPD) is the tendency to develop acute exacerbation, defined by the presence of different clinical findings as worsening dyspnea, increase in sputum purulence and volume. This study was designed to verify if definition of acute COPD exacerbation is applicable to patients who underwent pulmonary surgery, and if it has any impact on postoperative morbidity and mortality. Methods: This study was designed to prospectively enrol 1000 patients undergoing pulmonary resection for lung cancer from five different centres. Postoperative exacerbation of COPD was defined by the concomitant presence of three of the following five signs: deteriorating dyspnea, purulent sputum, bronchial secretion volume >10 ml/24 h, fever without apparent cause, and wheezing. The presence of concomitant pulmonary complications excluded the diagnosis of exacerbation, as they may present one or more of these signs. Results: In the absence of respiratory complications, postoperative stay in exacerbated patients was significantly longer as compared to patients without exacerbation (6.3 _ 1.3 vs 8.3 _ 1.1, p = 0.001). A postoperative exacerbation of COPD was recorded in 276 patients and 152 of them (55%) subsequently developed respiratory complications. Multivariate analysis established that risk factors for postoperative exacerbation are sex (female OR 0.54, CI 0.2—0.8), COPD class (OR 1.5, CI 1.1—8.1), and the postoperative prolonged use of antibiotics (OR 0.6, CI 0.2— 0.9). Conclusions: Postoperative exacerbation of COPD is an existing, frequent clinical entity after lung resection and, when present, it increases the risk of pulmonary complications. The existing guidelines for the treatment of acute exacerbation should be adapted for the management of patients after lung resection in order to test the hypothesis that they could reduce respiratory morbidity

Postoperative exacerbation of chronic obstructive pulmonary disease. Does it exists? / F., Leo; N., Venissac; D., Pop; P., Solli; Filosso, Pier Luigi; A., Minniti; D., Radice; J., Mouroux; L., Spaggiari; U., Pastorino; J., Jougon; Jf, Velly; Oliaro, Alberto. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 33:(2008), pp. 424-429.

Postoperative exacerbation of chronic obstructive pulmonary disease. Does it exists?

FILOSSO, Pier Luigi;
2008-01-01

Abstract

Background: One of the characteristics of chronic obstructive pulmonary disease (COPD) is the tendency to develop acute exacerbation, defined by the presence of different clinical findings as worsening dyspnea, increase in sputum purulence and volume. This study was designed to verify if definition of acute COPD exacerbation is applicable to patients who underwent pulmonary surgery, and if it has any impact on postoperative morbidity and mortality. Methods: This study was designed to prospectively enrol 1000 patients undergoing pulmonary resection for lung cancer from five different centres. Postoperative exacerbation of COPD was defined by the concomitant presence of three of the following five signs: deteriorating dyspnea, purulent sputum, bronchial secretion volume >10 ml/24 h, fever without apparent cause, and wheezing. The presence of concomitant pulmonary complications excluded the diagnosis of exacerbation, as they may present one or more of these signs. Results: In the absence of respiratory complications, postoperative stay in exacerbated patients was significantly longer as compared to patients without exacerbation (6.3 _ 1.3 vs 8.3 _ 1.1, p = 0.001). A postoperative exacerbation of COPD was recorded in 276 patients and 152 of them (55%) subsequently developed respiratory complications. Multivariate analysis established that risk factors for postoperative exacerbation are sex (female OR 0.54, CI 0.2—0.8), COPD class (OR 1.5, CI 1.1—8.1), and the postoperative prolonged use of antibiotics (OR 0.6, CI 0.2— 0.9). Conclusions: Postoperative exacerbation of COPD is an existing, frequent clinical entity after lung resection and, when present, it increases the risk of pulmonary complications. The existing guidelines for the treatment of acute exacerbation should be adapted for the management of patients after lung resection in order to test the hypothesis that they could reduce respiratory morbidity
33
424
429
Postoperative exacerbation of chronic obstructive pulmonary disease. Does it exists? / F., Leo; N., Venissac; D., Pop; P., Solli; Filosso, Pier Luigi; A., Minniti; D., Radice; J., Mouroux; L., Spaggiari; U., Pastorino; J., Jougon; Jf, Velly; Oliaro, Alberto. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 33:(2008), pp. 424-429.
F., Leo; N., Venissac; D., Pop; P., Solli; Filosso, Pier Luigi; A., Minniti; D., Radice; J., Mouroux; L., Spaggiari; U., Pastorino; J., Jougon; Jf, Velly; Oliaro, Alberto
File in questo prodotto:
File Dimensione Formato  
filosso 2007 european journal....pdf

non disponibili

Dimensione 98.7 kB
Formato Adobe PDF
98.7 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1294874
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 10
social impact