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

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. Preoperative
cough, shortness of breath, consolidation, abnormally low percentage predicted FEV1 and
FVC were associated with PPCs.