Open AccessEffect of perioperative systemic steroid treatment on patients with obstructive lung disease undergoing elective abdominal surgery
Author(s) -
Lee Hyun Woo,
Lee Jung Kyu,
Oh So Hee,
Kim Deog Kyeom,
Chung Hee Soon,
Heo Eun Young
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12520
Subject(s) - medicine , perioperative , abdominal surgery , spirometry , odds ratio , retrospective cohort study , surgery , anesthesia , asthma
Chronic obstructive pulmonary disease is an independent risk factor of postoperative pulmonary complications (PPCs). It is unknown whether a perioperative systemic corticosteroid would be beneficial in patients with obstructive airway disease. Objectives The present study was conducted to determine the effect of a perioperative systemic corticosteroid on PPCs in patients who showed airway obstruction in preoperative spirometry. Methods Retrospective medical record reviews were performed on records from January 2010 to December 2011 in a referral hospital. We analyzed the data of patients who were referred to pulmonologists before elective abdominal surgery and had a prebronchodilator FEV1/FVC of <70%. We compared the PPCs between the steroid group and the non‐steroid group. Results A total of 270 patients were referred to pulmonologists and, of these, 86 had a FEV1/FVC of <70% in the preoperative spirometry. In the 30 patients in the steroid group, the mean FEV1 was 52.2% and half of these had previously used a bronchodilator. Use of a perioperative systemic corticosteroid was significantly associated with reduced incidence of PPCs in the multivariate logistic regression with adjustment by propensity score (adjusted odds ratio = 0.036, 95% confidence interval [CI] = 0.003–0.505; P = 0.014). Conclusion In our retrospective study we showed that those treated with steroids had better outcomes. However, future prospective and randomized controlled trials are needed.