Preoperative pulmonary evaluation: which parameters determine the surgical outcome.

ABSTRACT

In order to find out the correlation between preoperative pulmonary and nonpulmonary variables and the outcome of surgery, one hundred and five cases who had preoperative pulmonary evaluation were included in the study. Of 105 cases, 88 cases underwent surgery. The majority of the cases were old (62.5 +/- 9.63 yrs), with no chest symptoms and signs. The spirometric values in most cases were normal. Most of them were smokers, with the diagnosis of carcinoma of esophagus and underwent thoracoabdominal surgery. Postoperative pulmonary complication was found in 58 cases and mortality was encountered in 12 cases. FEV1, FEF 25-75 per cent and PFEF 25-75 per cent could discriminate survival from death. Duration of surgery (DS) and age factors could predict post-operative pulmonary complication. Only DS could predict prolonged hospital stay, when PFEF 25-75 per cent was coupled with DS, it could predict survival. It was concluded that multiple factors other than spirometric values were responsible for the surgical outcome. They should be taken into consideration for preoperative pulmonary evaluation.