Chest
Original ResearchCOPDImpact of COPD on Postoperative Outcomes: Results From a National Database
Section snippets
Data Set
Data were extracted from the 2007 and 2008 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Participant Use Data Files.6 These are multicenter, prospective databases of 183 (year 2007) and 211 (year 2008) participating academic and private US hospitals. In 2007, NSQIP collected data on 136 variables (135 in 2008) for patients who underwent major surgical procedures in both the inpatient and the outpatient setting. In NSQIP, a participating hospital's surgical
Demographics
Of the 468,795 patients who underwent surgery, 57.3% were women, and the mean age was 55.0 ± 17.0 years. The overall mean BMI was 30.8 ± 11.2 kg/m2 (interquartile range [IQR], 25.0-34.6 kg/m2); patients with COPD had a significantly lower BMI (P < .0001) and tended to be older than patients without COPD (P < .0001) (Table 2).
Preoperative Comorbidities and Therapy Characteristics
Cardiovascular, renal, neurologic, infectious, liver, and respiratory comorbidities were more commonly seen in patients with COPD than in those without COPD (P < .0001) (
Discussion
The prevalence of COPD is higher among surgical candidates than among age-matched population groups.5 There is, however, a paucity of high-quality studies addressing the association of complications in patients with COPD undergoing surgery. Some studies have shown adverse postoperative outcomes in patients with COPD,14., 15., 16. but these studies have been limited to certain surgical subspecialties with a small number of patients.
In the present study, we included patients from all specialties
Acknowledgments
Author contributions: Dr P. Gupta had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr H. Gupta: contributed to all aspects of the manuscript.
Dr Ramanan: contributed to all aspects of the manuscript.
Dr P. Gupta: contributed to all aspects of the manuscript.
Dr Fang: contributed to all aspects of the manuscript.
Dr Polich: contributed to all aspects of the manuscript.
Dr Modrykamien: contributed to all
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Part of this article was presented at the CHEST Annual Meeting, October 26-31, 2010, Vancouver, BC, Canada.
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.