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Revista Médica del Uruguay

On-line version ISSN 1688-0390

Abstract

TEJERA, Darwin et al. Complicaciones y mortalidad de la cirugía de resección pulmonar en unidades de medicina intensiva. Rev. Méd. Urug. [online]. 2014, vol.30, n.1, pp.8-16. ISSN 1688-0390.

Abstract Objective: to describe frequency of post-operative complications and mortality in a number of patients undergoing a programmed pulmonary resection surgery who were admitted to intensive care units (ICU) immediately after surgery. Method: observational, retrospective, multi-center study conducted in four health institutions in Montevideo, between 2009 and 2010. One hundred and forty eight patients were included to study demographic variables, personal history, indications and surgical procedure, complications ICU-stay and mortality. A descriptive, statistical, two-variable analysis was conducted, a 95% confidence interval was deemed significant, and p was < 0,05. Results: crude post-surgery mortality rate during stay in the ICU was 10.1%. Incidence of postoperative complications was 53.3%, being average stay three days with a interquartile range of 3. The main complications were pulmonary, pleural and cardiovascular. Mortality was higher in larger pulmonary resections, patients with chronic obstruction pulmonary disease and in those who evidences respiratory and cardiovascular complications. The main cause of death was severe sepsis. The development of severe sepsis (OR 12.9 IC95%, 5.95-21.24 p < 0,001) and the need for mechanical ventilation (OR 3.7 IC95%, 1.80-8.93 p = 0,001) were independent risk factors associated to mortality. Conclusions: postoperative morbi-mortality during stay in the ICU is high. The main complications are respiratory and cardiovascular. Development of severe sepsis la morbi-mortalidad and the need for mechanical ventilation were independent factors associated to a higher mortality.

Keywords : THORACIC SURGERY; PNEUMONECTOMY; POSTOPERATIVE COMPLICATIONS; CRITICAL CARE.

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