Impact of GOLD groups of chronic pulmonary obstructive disease on surgical complications

Abstract

Purpose

Chronic obstructive pulmonary disease (COPD) is associated with increased postoperative complications. Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classified COPD patients into four groups based on spirometry results and the severity of symptoms. The objective of this study was to evaluate the impact of GOLD groups on postoperative complications.

Patients and methods

We reviewed the medical records of COPD patients who underwent preoperative spirometry between April and August 2013 at a tertiary hospital in Korea. We divided the patients into GOLD groups according to the results of spirometry and self-administered questionnaires that assessed the symptom severity and exacerbation history. GOLD groups, demographic characteristics, and operative conditions were analyzed.

Results

Among a total of 405 COPD patients, 70 (17.3%) patients experienced various postoperative complications, including infection, wound, or pulmonary complications. Thoracic surgery, upper abdominal surgery, general anesthesia, large estimated blood loss during surgery, and longer anesthesia time were significant risk factors for postoperative complications. Patients in high-risk group (GOLD groups C or D) had an increased risk of postoperative complications compared to those in low-risk group (GOLD groups A or B).

Conclusion

COPD patients in GOLD groups representing a high exacerbation risk have an increased risk of postoperative complications compared to those with low risk.

Keywords:

• chronic obstructive pulmonary disease
• dyspnea
• postoperative complications
• risk assessment
• spirometry

Supplementary materials

Table S1 Multivariate analysis of postoperative pulmonary complications, infection, and wound complications

Table S2 Relationship between dyspnea and postoperative complications

Author contributions

SMC and HJK contributed to conception and design of the study, and acquisition, and analysis of data. JL, YSP, CHL, SML, JJY, CGY, YWK, and SKH contributed to study design and interpretation of data. SMC and HJK drafted the manuscript. JL, YSP, CHL, SML, JJY, CGY, YWK, and SKH revised the manuscript. All authors had access to the final version of the manuscript, and approved the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure

The authors report no conflicts of interest in this work.