The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Perioperative Medicine
Abstract
Background: The burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical
problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal
anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at
greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of
post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge.
The objective of the study was to determine the pulmonary complications developing after abdominal and thoracic
surgery and the associated risks factors.
Methods: A retrospective records review of all abdominal and thoracic surgery patients admitted at a central hospital
from January 2014 to October 2014 was done. Data collected included demographic data, surgical history,
comorbidities and the PPCs present.
Results: Out of the 92 patients whose records were reviewed, 55 (59.8%) were males and 84 (91.3%) had abdominal
surgery. The mean age of the patients was 42.6 years (SD = 18.4). The common comorbidities were HIV infection noted
in 14(15.2%) of the patients and hypertension in 10 (13.0%). Thirty nine (42.4%) developed PPCs and the most common
complications were nosocomial pneumonia in 21 (22.8%) patients, ventilator associated pneumonia in 11 (12.0%), and
atelectasis in 6 (6.5%) patients. Logistic regression showed that a history of alcohol consumption, prolonged surgery,
prolonged stay in hospital or critical care unit, incision type, and comorbidities were significant risk factors for
PPCs (p < 0.05). The mortality rate was 10.9%.
Conclusion: PPCs like nosocomial and ventilator associated pneumonia were common and were associated
with increased morbidity and adversely affected clinical outcomes of patients. HIV and hypertension presented
significant comorbidities which the health team needed to recognize and address. Strategies to reduce the
occurrence of PPCs have to be implemented through coordinated efforts by the health practitioners as a team
during the entire perioperative period.
Keywords: Abdominal surgery, Thoracic surgery, Post-operative complications, Pulmonary complications, HIV infection,
Comorbidities
Description
Journal Article
Keywords
Abdominal surgery, Thoracic surgery, Post-operative complications, Pulmonary complications, HIV infection, Comorbidities
Citation
Tadyanemhandu C. et al. 2017. The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study.