Postoperative pulmonary complications

Postoperative pulmonary complications affect 13% of patients undergoing upper abdominal laparotomy. This study measured the incidence of postoperative pulmonary complications, risk factors for the diagnosis of postoperative pulmonary complications and barriers to physiotherapy mobilisation. 

Two surgical wards in a tertiary Australian hospital were used for the prospective Observational cohort study. 72 patients undergoing high-risk abdominal surgery (participants in a larger trial evaluating a novel model of medical co-management) were recruited. 

The incidence of post-op pulmonary complications was 39%. Incision type and time to mobilise away from the bed were independently associated with a diagnosis of post-op pulmonary complications. Patients were 3.0 (95% CI 1.2 to 8.0) times more likely to develop a post-op pulmonary complication for each day they did not mobilise away from the bed. 

52% of patients had a barrier to mobilisation away from the bed on the first post-op day, with the most common barrier being hypotension. Development of a post-op pulmonary complication increased median hospital length of stay (16 vs 13 days; P = 0.046). This study demonstrated an association between delayed mobilisation and postoperative pulmonary complications. RCTs are indicated to test the role of early mobilisation in preventing postoperative pulmonary complications in patients undergoing high-risk upper abdominal surgery > from Haines et al.; Physiotherapy (2013) Ahead of Print. All rights reserved to the Chartered Society of Physiotherapy.