The value of preoperative spirometry testing for predicting postoperative risk in upper abdominal and thoracic surgery assessed using big-data analysis

• DOI: 10.21037/jtd-19-2687
• Publication Date: 2020-08-20T01:41:42Z
• Authors: Hyung Jun Park; Sung min Kim; Hong Rae Kim; Wonjun Ji; Chang-Min Choi
• Keywords: Vital capacity; Cardiothoracic surgery

Spirometry is used to evaluate postoperative outcomes in thoracic surgery. However, the clinical utility of spirometry for predicting complications has not been determined. We big-data analysis examine relationship between pulmonary function tests and complications.We retrospectively analysed data from 31,827 patients who underwent within 3 months prior their surgery January 2000 December 2014 at a single tertiary referral hospital. The were extracted de-identified form via automated research information system. Surgical procedures included upper abdominal surgery.Multivariable logistic regression showed that type surgery, older age (>65 years), low albumin smoking associated with infections [95% confidence interval (CI) odds ratio (OR) 1.27-1.60 years); 1.52-1.96 (low albumin); 1.40-1.98 (current smoker)]. Notably, lower forced vital capacity (FVC) was an independent risk factor infection, prolonged intensive care unit stay, in-hospital death, regardless airflow limitation [OR 95% CI: 1.31-1.69 (FVC 50-80%); 2.02-4.24 <50%)]. Lower expiratory volume 1 sec (FEV1) also infection 1.61-2.26 (FEV1 2.27-4.21 Airflow assessed by FEV1 negatively correlated multivariable (OR 0.51-0.88).Lower preoperative FVC could be predict limitation.