Pre-operative Pulmonary Assessment and Risk Factors for Post-operative Pulmonary Complications in Elective Abdominal Surgery in Nigeria

Chinyelu Uchenna Ufoaroh; Prince Udegbunam Ele; Arthur Ebelenna Anyabolu; Emeka Hyacinth Enemuo; Chiemelu Dickson Emegoakor; Chinedu Christian Okoli; Eric Okechukwu Umeh; Ernest Ndukaife Anyabolu

Chinyelu Uchenna Ufoaroh Department of Medicine, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Nigeria.
Prince Udegbunam Ele Department of Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
Arthur Ebelenna Anyabolu Department of Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
Emeka Hyacinth Enemuo Department of Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria.
Chiemelu Dickson Emegoakor Department of Surgery, Nnamdi Azikiwe University, Nigeria.
Chinedu Christian Okoli Department of Surgery, Nnamdi Azikiwe University, Nigeria.
Eric Okechukwu Umeh Department of Radiology, Nnamdi Azikiwe University Teaching Hospital, Nigeria.
Ernest Ndukaife Anyabolu Department of Medicine, Chukwuemeka Odumegwu Ojukwu University, Imo State University, Nigeria.

Keywords: Post-operative pulmonary complications, pre-operative assessment, risk factors, cough, shortness of breath, consolidation, pneumonia, elective abdominal surgeries, Nnewi, Nigeria

Abstract

Post-operative pulmonary complications (PPCs) are recurring causes of rising morbidity and mortality in surgeries. This study sought to evaluate pre-operative risk factors for PPCs in abdominal surgery patients in Nigeria. This was a prospective study in patients booked for surgery in 2014. Biodata, medical history, pre-operative respiratory and cardiovascular examination findings, body mass index, serum albumin, serum urea, ventilatory function, chest x-rays and oxygen saturation were obtained. The association between pre-operative variables and PPCs was determined. The pre-operative spirometry was predominantly restrictive (62%). Overall, the prevalence of PPCs was 52%. This included non-productive cough (14%), isolated productive cough (10%), productive cough with abnormal chest finding (16%), pneumonia (8%), pleural effusion (5%), ARDS (2%). Percentage predicted FEV1 and FVC were lower in participants with PPCs. (p= 0.03 and p=0.01 respectively). Pre-operative cough, shortness of breath and consolidation were associated with PPCs (p< 0.05). Post-operative respiratory rate and pulse rate in participants with PPCs were higher than the values in those without PPCs (p=0.03 and p=0.05). The prevalence of PPCs was high in this study. Pre-operative cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and FVC were associated with PPCs.