THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.933 |
Resumo: | Background: Preoperative evaluation before pulmonary surgery typically do not include the assessment of respiratory muscle function, which might be a predictor of postoperative pulmonary complications (PPC). Objectives: To ascertain whether preoperative respiratory muscle function predicts PPC in patients submitted to pulmonary resection by thoracotomy. Methods: Beyond pulmonary and respiratory muscle functions assessments, physical fitness was evaluated with the 6-minute walking test. We registered PPC occurring up to 30 days after hospital discharge. Discriminant function analysis was carried out to identify which variables were the best predictors of PPC. Logistic regression was used to analyse associations between variables of respiratory muscle function and PPC. Results: Patients with PPC (n=20), compared to those without PPC (n=85), had significant heavy smoking habits (t=-2.412; p=0.027; d=0.547), decreased forced expiratory volume in the first second (FEV1; t=-2.932; p=0.004; d=0.703), peak expiratory flow (PEF; t=-2.412; p=0.018; d=0.586), diffusion capacity for carbon monoxide (DLCO; t=2.183; p=0.039; d=0.673). Regarding respiratory muscle function, maximal expiratory pressure was significantly reduced in patients with PPC (MEP; t=3.116; p=0.002; d=0.744). Discriminant function structural coefficients showed that MEP % (-0.519), FEV1 % (-0.488), DLCO % (-0.465), PEF % (-0.402) and cigarettes pack-year (0.374) were the most important factors to discriminate groups with and without PPC. Results from logistic regression indicate that those patients with lower MEP (%) have an increased risk of PPC (OR=7.440; 95% CI= 1.228 – 19.471). Conclusion: Preoperative maximal expiratory pressure was the strongest predictor of PPC and should be considered for risk assessment in surgical candidates. |
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THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTIONO PAPEL DA FUNÇÃO DOS MÚSCULOS RESPIRATÓRIOS COMO PREDITOR DE COMPLICAÇÕES PULMONARES PÓS-OPERATÓRIAS DE RESSECÇÃO PULMONARBackground: Preoperative evaluation before pulmonary surgery typically do not include the assessment of respiratory muscle function, which might be a predictor of postoperative pulmonary complications (PPC). Objectives: To ascertain whether preoperative respiratory muscle function predicts PPC in patients submitted to pulmonary resection by thoracotomy. Methods: Beyond pulmonary and respiratory muscle functions assessments, physical fitness was evaluated with the 6-minute walking test. We registered PPC occurring up to 30 days after hospital discharge. Discriminant function analysis was carried out to identify which variables were the best predictors of PPC. Logistic regression was used to analyse associations between variables of respiratory muscle function and PPC. Results: Patients with PPC (n=20), compared to those without PPC (n=85), had significant heavy smoking habits (t=-2.412; p=0.027; d=0.547), decreased forced expiratory volume in the first second (FEV1; t=-2.932; p=0.004; d=0.703), peak expiratory flow (PEF; t=-2.412; p=0.018; d=0.586), diffusion capacity for carbon monoxide (DLCO; t=2.183; p=0.039; d=0.673). Regarding respiratory muscle function, maximal expiratory pressure was significantly reduced in patients with PPC (MEP; t=3.116; p=0.002; d=0.744). Discriminant function structural coefficients showed that MEP % (-0.519), FEV1 % (-0.488), DLCO % (-0.465), PEF % (-0.402) and cigarettes pack-year (0.374) were the most important factors to discriminate groups with and without PPC. Results from logistic regression indicate that those patients with lower MEP (%) have an increased risk of PPC (OR=7.440; 95% CI= 1.228 – 19.471). Conclusion: Preoperative maximal expiratory pressure was the strongest predictor of PPC and should be considered for risk assessment in surgical candidates.Introdução: A avaliação pré-operatória para cirurgia pulmonar geralmente não inclui a avaliação da função muscular respiratória, a qual pode ser um preditor de complicações pulmonares pós-operatórias (CPP). Objetivos: Verificar se a função muscular respiratória pré-operatória prediz CPP em doentes submetidos a ressecção pulmonar por toracotomia. Métodos: Além das avaliações das funções musculares pulmonares e respiratórias, a aptidão física foi avaliada através do teste de marcha de 6 minutos. Foram registadas as CPP até 30 dias após a alta hospitalar. A análise da função discriminante foi realizada para identificar quais as variáveis que atuam como melhores preditores de CPP. Foi utilizada regressão logística para analisar a associação entre as variáveis da função muscular respiratória e a CPP. Resultados: Doentes com CPP (n = 20), em comparação com aqueles que não desenvolveram CPP (n = 85), apresentaram hábito tabágico pesado significativo (t = –2,412; p = 0,027; d = 0,547), diminuição do volume expiratório forçado no primeiro segundo (FEV1; t = –2,932; p = 0,004; d = 0,703), do pico de fluxo expiratório (PEF; t = –2,412; p = 0,018; d = 0,586) e da capacidade de difusão de monóxido de carbono (DLCO; t = 2,183; p = 0,039; d = 0,673). Em relação à função muscular respiratória, a pressão expiratória máxima estava significativamente reduzida nos doentes com CPP (PEmáx; t = 3,116; p = 0,002; d = 0,744). Os coeficientes estruturais da função discriminante mostraram que a pressão expiratória máxima (MEP%; –0,519), o FEV1 % (-0,488), a DLCO% (-0,465), o PEF% (-0,402) e os maços de cigarros por ano (0,374) foram os fatores mais importantes para discriminar os doentes que desenvolveram CPP. Os resultados da regressão logística indicaram que os doentes com menor PEmáx (%) apresentam risco aumentado de CPP (OR = 7,440; IC 95% = 1,228 – 19,471). Conclusão: A pressão expiratória máxima pré-operatória foi o preditor mais forte de CPP e deverá ser considerado para avaliação de risco em candidatos cirúrgicos.Sociedade Portuguesa de Cirurgia2022-02-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.933https://doi.org/10.34635/rpc.933Revista Portuguesa de Cirurgia; No 51 (2021): Number 51 - October 2021; 63-73Revista Portuguesa de Cirurgia; No 51 (2021): Number 51 - October 2021; 63-732183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/933https://revista.spcir.com/index.php/spcir/article/view/933/620Copyright (c) 2021 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessKendal, FilipaSilva, GustavoDrummond, MartaViana, PauloPinho, PauloOliveira, JoséTeixeira Bastos, Pedro2024-03-14T22:04:37Zoai:revista.spcir.com:article/933Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:40.397803Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION O PAPEL DA FUNÇÃO DOS MÚSCULOS RESPIRATÓRIOS COMO PREDITOR DE COMPLICAÇÕES PULMONARES PÓS-OPERATÓRIAS DE RESSECÇÃO PULMONAR |
title |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
spellingShingle |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION Kendal, Filipa |
title_short |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
title_full |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
title_fullStr |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
title_full_unstemmed |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
title_sort |
THE PREDICTIVE ROLE OF RESPIRATORY MUSCLE FUNCTION ON POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION |
author |
Kendal, Filipa |
author_facet |
Kendal, Filipa Silva, Gustavo Drummond, Marta Viana, Paulo Pinho, Paulo Oliveira, José Teixeira Bastos, Pedro |
author_role |
author |
author2 |
Silva, Gustavo Drummond, Marta Viana, Paulo Pinho, Paulo Oliveira, José Teixeira Bastos, Pedro |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Kendal, Filipa Silva, Gustavo Drummond, Marta Viana, Paulo Pinho, Paulo Oliveira, José Teixeira Bastos, Pedro |
description |
Background: Preoperative evaluation before pulmonary surgery typically do not include the assessment of respiratory muscle function, which might be a predictor of postoperative pulmonary complications (PPC). Objectives: To ascertain whether preoperative respiratory muscle function predicts PPC in patients submitted to pulmonary resection by thoracotomy. Methods: Beyond pulmonary and respiratory muscle functions assessments, physical fitness was evaluated with the 6-minute walking test. We registered PPC occurring up to 30 days after hospital discharge. Discriminant function analysis was carried out to identify which variables were the best predictors of PPC. Logistic regression was used to analyse associations between variables of respiratory muscle function and PPC. Results: Patients with PPC (n=20), compared to those without PPC (n=85), had significant heavy smoking habits (t=-2.412; p=0.027; d=0.547), decreased forced expiratory volume in the first second (FEV1; t=-2.932; p=0.004; d=0.703), peak expiratory flow (PEF; t=-2.412; p=0.018; d=0.586), diffusion capacity for carbon monoxide (DLCO; t=2.183; p=0.039; d=0.673). Regarding respiratory muscle function, maximal expiratory pressure was significantly reduced in patients with PPC (MEP; t=3.116; p=0.002; d=0.744). Discriminant function structural coefficients showed that MEP % (-0.519), FEV1 % (-0.488), DLCO % (-0.465), PEF % (-0.402) and cigarettes pack-year (0.374) were the most important factors to discriminate groups with and without PPC. Results from logistic regression indicate that those patients with lower MEP (%) have an increased risk of PPC (OR=7.440; 95% CI= 1.228 – 19.471). Conclusion: Preoperative maximal expiratory pressure was the strongest predictor of PPC and should be considered for risk assessment in surgical candidates. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-02-02 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.933 https://doi.org/10.34635/rpc.933 |
url |
https://doi.org/10.34635/rpc.933 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/933 https://revista.spcir.com/index.php/spcir/article/view/933/620 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 51 (2021): Number 51 - October 2021; 63-73 Revista Portuguesa de Cirurgia; No 51 (2021): Number 51 - October 2021; 63-73 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799138181950472192 |