Impact of COPD on postoperative outcomes: Results from a national database

Himani Gupta, Bala Ramanan, Prateek K. Gupta, Xiang Fang, Ann Polich, Ariel Modrykamien, Dan Schuller, Lee E. Morrow

Research output: Contribution to journalArticle

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Abstract

Background: Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. Methods: Patients with COPD who underwent surgery were identified from the National Surgical Quality Improvement Program database (2007-2008). Univariate and multivariate analyses were performed on this multicenter, prospective data set (N = 468,795). Results: COPD was present in 22,576 patients (4.82%). These patients were more likely to be older, men, white, smokers, and taking corticosteroids and had a lower BMI (P<.0001 for each). Median length of stay was 4 days for patients with COPD vs 1 day in those without COPD (P<.0001). Thirty-day morbidity rates were 25.8% and 10.2% for patients with and without COPD, respectively (P<.0001). Thirty-day death rates were 6.7% and 1.4% for patients with and without COPD, respectively (P<.0001). After controlling for > 50 comorbidities through logistic regression modeling, COPD was independently associated with higher postoperative morbidity (OR, 1.35; 95% CI, 1.30-1.40; P<.0001) and mortality (OR, 1.29; 95% CI, 1.19-1.39; P<.0001). Multivariate analyses with each individual postoperative complication as the outcome of interest showed that COPD was associated with increased risk for postoperative pneumonia, respiratory failure, myocardial infarction, cardiac arrest, sepsis, return to the operating room, and renal insufficiency or failure (P<.05 for each). Conclusions: COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.

Original languageEnglish (US)
Pages (from-to)1599-1606
Number of pages8
JournalChest
Volume143
Issue number6
DOIs
StatePublished - Jan 1 2013

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Chronic Obstructive Pulmonary Disease
Databases
Length of Stay
Morbidity
Renal Insufficiency
Mortality
Multivariate Analysis
Operating Rooms
Quality Improvement
Heart Arrest
Respiratory Insufficiency
Comorbidity
Sepsis
Pneumonia
Adrenal Cortex Hormones
Logistic Models
Myocardial Infarction
Population

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Gupta, H., Ramanan, B., Gupta, P. K., Fang, X., Polich, A., Modrykamien, A., ... Morrow, L. E. (2013). Impact of COPD on postoperative outcomes: Results from a national database. Chest, 143(6), 1599-1606. https://doi.org/10.1378/chest.12-1499

Impact of COPD on postoperative outcomes : Results from a national database. / Gupta, Himani; Ramanan, Bala; Gupta, Prateek K.; Fang, Xiang; Polich, Ann; Modrykamien, Ariel; Schuller, Dan; Morrow, Lee E.

In: Chest, Vol. 143, No. 6, 01.01.2013, p. 1599-1606.

Research output: Contribution to journalArticle

Gupta, H, Ramanan, B, Gupta, PK, Fang, X, Polich, A, Modrykamien, A, Schuller, D & Morrow, LE 2013, 'Impact of COPD on postoperative outcomes: Results from a national database', Chest, vol. 143, no. 6, pp. 1599-1606. https://doi.org/10.1378/chest.12-1499
Gupta H, Ramanan B, Gupta PK, Fang X, Polich A, Modrykamien A et al. Impact of COPD on postoperative outcomes: Results from a national database. Chest. 2013 Jan 1;143(6):1599-1606. https://doi.org/10.1378/chest.12-1499
Gupta, Himani ; Ramanan, Bala ; Gupta, Prateek K. ; Fang, Xiang ; Polich, Ann ; Modrykamien, Ariel ; Schuller, Dan ; Morrow, Lee E. / Impact of COPD on postoperative outcomes : Results from a national database. In: Chest. 2013 ; Vol. 143, No. 6. pp. 1599-1606.
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AU - Ramanan, Bala

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AU - Fang, Xiang

AU - Polich, Ann

AU - Modrykamien, Ariel

AU - Schuller, Dan

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N2 - Background: Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. Methods: Patients with COPD who underwent surgery were identified from the National Surgical Quality Improvement Program database (2007-2008). Univariate and multivariate analyses were performed on this multicenter, prospective data set (N = 468,795). Results: COPD was present in 22,576 patients (4.82%). These patients were more likely to be older, men, white, smokers, and taking corticosteroids and had a lower BMI (P<.0001 for each). Median length of stay was 4 days for patients with COPD vs 1 day in those without COPD (P<.0001). Thirty-day morbidity rates were 25.8% and 10.2% for patients with and without COPD, respectively (P<.0001). Thirty-day death rates were 6.7% and 1.4% for patients with and without COPD, respectively (P<.0001). After controlling for > 50 comorbidities through logistic regression modeling, COPD was independently associated with higher postoperative morbidity (OR, 1.35; 95% CI, 1.30-1.40; P<.0001) and mortality (OR, 1.29; 95% CI, 1.19-1.39; P<.0001). Multivariate analyses with each individual postoperative complication as the outcome of interest showed that COPD was associated with increased risk for postoperative pneumonia, respiratory failure, myocardial infarction, cardiac arrest, sepsis, return to the operating room, and renal insufficiency or failure (P<.05 for each). Conclusions: COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.

AB - Background: Although COPD affects large sections of the population, its effects on postoperative outcomes have not been rigorously studied. The objectives of this study were to describe the prevalence of COPD in patients undergoing surgery and to analyze the associations between COPD and postoperative morbidity, mortality, and hospital length of stay. Methods: Patients with COPD who underwent surgery were identified from the National Surgical Quality Improvement Program database (2007-2008). Univariate and multivariate analyses were performed on this multicenter, prospective data set (N = 468,795). Results: COPD was present in 22,576 patients (4.82%). These patients were more likely to be older, men, white, smokers, and taking corticosteroids and had a lower BMI (P<.0001 for each). Median length of stay was 4 days for patients with COPD vs 1 day in those without COPD (P<.0001). Thirty-day morbidity rates were 25.8% and 10.2% for patients with and without COPD, respectively (P<.0001). Thirty-day death rates were 6.7% and 1.4% for patients with and without COPD, respectively (P<.0001). After controlling for > 50 comorbidities through logistic regression modeling, COPD was independently associated with higher postoperative morbidity (OR, 1.35; 95% CI, 1.30-1.40; P<.0001) and mortality (OR, 1.29; 95% CI, 1.19-1.39; P<.0001). Multivariate analyses with each individual postoperative complication as the outcome of interest showed that COPD was associated with increased risk for postoperative pneumonia, respiratory failure, myocardial infarction, cardiac arrest, sepsis, return to the operating room, and renal insufficiency or failure (P<.05 for each). Conclusions: COPD is common among patients undergoing surgery and is associated with increased morbidity, mortality, and length of stay.

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