Model for predicting early and late-onset postoperative pulmonary complications in perioperative patients receiving neuromuscular blockade: a secondary analysis

• Published in: Scientific reports Vol. 13; no. 1; p. 5234
• Main Authors: Aragón-Benedí, Cristian, Oliver-Forniés, Pablo, Pascual-Bellosta, Ana, Ortega-Lucea, Sonia, Ramírez-Rodriguez, José Manuel, Martínez-Ubieto, Javier
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 31.03.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/499; Airway management; Airway Obstruction - etiology; Anesthesia; Anesthetics; Atelectasis; Cohort Studies; Diabetes mellitus; Humanities and Social Sciences; Humans; Hypoxemia; Hypoxia - etiology; multidisciplinary; Neuromuscular Blockade - adverse effects; Neuromuscular Diseases - etiology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prediction models; Pulmonary Atelectasis - epidemiology; Pulmonary Atelectasis - etiology; Respiration Disorders - etiology; Respiratory tract; Risk factors; Science; Science (multidisciplinary); Secondary analysis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-32017-5

Pulmonary complications continue to be the most common adverse event after surgery. The main objective was to carry out two independent predictive models, both for early pulmonary complications in the Post-Anesthesia Care Unit and late-onset pulmonary complications after 30 postoperative days. The secondary objective was to determine whether presenting early complications subsequently causes patients to have other late-onset events. This is a secondary analysis of a cohort study. 714 patients were divided into four groups depending on the neuromuscular blocking agent, and spontaneous or pharmacological reversal. Incidence of late-onset complications if we have not previously had any early complications was 4.96%. If the patient has previously had early complications the incidence of late-onset complications was 22.02%. If airway obstruction occurs, the risk of atelectasis increased from 6.88 to 22.58% (p = 0.002). If hypoxemia occurs, the incidence increased from 5.82 to 21.79% (p < 0.001). Based on our predictive models, we conclude that diabetes mellitus and preoperative anemia are two risk factors for early and late-onset postoperative pulmonary complications, respectively. Hypoxemia and airway obstruction in Post-Anesthesia Care Unit increased four times the risk of the development of pneumonia and atelectasis at 30 postoperative days.