Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease
Abstract This study assessed whether perioperative management is associated with postoperative acute exacerbations (AEs) in interstitial lung disease (ILD) patients. Using secondary data from the study “Postoperative acute exacerbation of interstitial lung disease: a case–control study,” we compared...
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| Format: | Article |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41152-y |
| _version_ | 1797452807835484160 |
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| author | Fumiko Seto Gaku Kawamura Keisuke Hosoki Michiko Ushio Taisuke Jo Kanji Uchida |
| author_facet | Fumiko Seto Gaku Kawamura Keisuke Hosoki Michiko Ushio Taisuke Jo Kanji Uchida |
| author_sort | Fumiko Seto |
| collection | DOAJ |
| description | Abstract This study assessed whether perioperative management is associated with postoperative acute exacerbations (AEs) in interstitial lung disease (ILD) patients. Using secondary data from the study “Postoperative acute exacerbation of interstitial lung disease: a case–control study,” we compared the perioperative clinical management of the AE and non-AE groups (1:4 case–control matching) selected by sex, year of surgery (2009–2011, 2012–2014, and 2015–2017), and multiple surgeries within 30 days. We compared 27 and 108 patients with and without AEs, respectively. Rates of one lung ventilation (OLV) cases (70 vs. 29%; OR, 5.9; 95%CI, 2.34–14.88; p < 0.001) and intraoperative steroid administration (48 vs. 26%; OR, 2.65; 95%CI, 1.11–6.33; p = 0.028), and average mean inspiratory pressure (9.2 [1.8] vs. 8.3 [1.7] cmH2O; OR, 1.36; 95%CI, 1.04–1.79; p = 0.026), were significantly higher in the AE group. There was a significant difference in OLV between the groups (OR, 4.99; 95%CI, 1.90–13.06; p = 0.001). However, the fraction of inspired oxygen > 0.8 lasting > 1 min (63 vs. 73%, p = 0.296) was not significantly different between the groups. OLV was significantly associated with postoperative AEs in patients with ILD undergoing both pulmonary and non-pulmonary surgeries. Thus, preoperative risk considerations are more important in patients who require OLV. |
| first_indexed | 2024-03-09T15:14:00Z |
| format | Article |
| id | doaj.art-bb73eae16c524afb96810d478c1663d2 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:14:00Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bb73eae16c524afb96810d478c1663d22023-11-26T13:12:54ZengNature PortfolioScientific Reports2045-23222023-08-011311710.1038/s41598-023-41152-ySecondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung diseaseFumiko Seto0Gaku Kawamura1Keisuke Hosoki2Michiko Ushio3Taisuke Jo4Kanji Uchida5Department of Anesthesiology, Faculty of Medicine, Graduate School of Medicine, The University of TokyoDepartment of Anesthesiology, Faculty of Medicine, Graduate School of Medicine, The University of TokyoDepartment of Respiratory Medicine, Graduate School of Medicine, The University of TokyoDepartment of Anesthesiology, Faculty of Medicine, Graduate School of Medicine, The University of TokyoDepartment of Respiratory Medicine, Graduate School of Medicine, The University of TokyoDepartment of Anesthesiology, Faculty of Medicine, Graduate School of Medicine, The University of TokyoAbstract This study assessed whether perioperative management is associated with postoperative acute exacerbations (AEs) in interstitial lung disease (ILD) patients. Using secondary data from the study “Postoperative acute exacerbation of interstitial lung disease: a case–control study,” we compared the perioperative clinical management of the AE and non-AE groups (1:4 case–control matching) selected by sex, year of surgery (2009–2011, 2012–2014, and 2015–2017), and multiple surgeries within 30 days. We compared 27 and 108 patients with and without AEs, respectively. Rates of one lung ventilation (OLV) cases (70 vs. 29%; OR, 5.9; 95%CI, 2.34–14.88; p < 0.001) and intraoperative steroid administration (48 vs. 26%; OR, 2.65; 95%CI, 1.11–6.33; p = 0.028), and average mean inspiratory pressure (9.2 [1.8] vs. 8.3 [1.7] cmH2O; OR, 1.36; 95%CI, 1.04–1.79; p = 0.026), were significantly higher in the AE group. There was a significant difference in OLV between the groups (OR, 4.99; 95%CI, 1.90–13.06; p = 0.001). However, the fraction of inspired oxygen > 0.8 lasting > 1 min (63 vs. 73%, p = 0.296) was not significantly different between the groups. OLV was significantly associated with postoperative AEs in patients with ILD undergoing both pulmonary and non-pulmonary surgeries. Thus, preoperative risk considerations are more important in patients who require OLV.https://doi.org/10.1038/s41598-023-41152-y |
| spellingShingle | Fumiko Seto Gaku Kawamura Keisuke Hosoki Michiko Ushio Taisuke Jo Kanji Uchida Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease Scientific Reports |
| title | Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| title_full | Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| title_fullStr | Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| title_full_unstemmed | Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| title_short | Secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| title_sort | secondary analysis of preoperative predictors for acute postoperative exacerbation in interstitial lung disease |
| url | https://doi.org/10.1038/s41598-023-41152-y |
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