The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study

dc.contributor.authorTadyanemhandu, Cathrine
dc.contributor.authorMukombachoto, Rufaro
dc.contributor.authorNhunzvi, Clement
dc.contributor.authorKaseke, Farayi
dc.contributor.authorChikwasha, Vasco
dc.contributor.authorChengetanai, Samson
dc.contributor.authorManie, Shamila
dc.date.accessioned2017-09-05T14:01:46Z
dc.date.available2017-09-05T14:01:46Z
dc.date.issued2017-08-22
dc.date.updated2017-08-27T03:16:18Z
dc.description.abstractBackground: The burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge. The objective of the study was to determine the pulmonary complications developing after abdominal and thoracic surgery and the associated risks factors. Methods: A retrospective records review of all abdominal and thoracic surgery patients admitted at a central hospital from January 2014 to October 2014 was done. Data collected included demographic data, surgical history, comorbidities and the PPCs present. Results: Out of the 92 patients whose records were reviewed, 55 (59.8%) were males and 84 (91.3%) had abdominal surgery. The mean age of the patients was 42.6 years (SD = 18.4). The common comorbidities were HIV infection noted in 14(15.2%) of the patients and hypertension in 10 (13.0%). Thirty nine (42.4%) developed PPCs and the most common complications were nosocomial pneumonia in 21 (22.8%) patients, ventilator associated pneumonia in 11 (12.0%), and atelectasis in 6 (6.5%) patients. Logistic regression showed that a history of alcohol consumption, prolonged surgery, prolonged stay in hospital or critical care unit, incision type, and comorbidities were significant risk factors for PPCs (p < 0.05). The mortality rate was 10.9%. Conclusion: PPCs like nosocomial and ventilator associated pneumonia were common and were associated with increased morbidity and adversely affected clinical outcomes of patients. HIV and hypertension presented significant comorbidities which the health team needed to recognize and address. Strategies to reduce the occurrence of PPCs have to be implemented through coordinated efforts by the health practitioners as a team during the entire perioperative period.
dc.identifier.apacitationTadyanemhandu, C., Mukombachoto, R., Nhunzvi, C., Kaseke, F., Chikwasha, V., Chengetanai, S., & Manie, S. (2017). The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study. <i>Perioperative Medicine</i>, http://hdl.handle.net/11427/25040en_ZA
dc.identifier.chicagocitationTadyanemhandu, Cathrine, Rufaro Mukombachoto, Clement Nhunzvi, Farayi Kaseke, Vasco Chikwasha, Samson Chengetanai, and Shamila Manie "The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study." <i>Perioperative Medicine</i> (2017) http://hdl.handle.net/11427/25040en_ZA
dc.identifier.citationPerioperative Medicine. 2017 Aug 22;6(1):11
dc.identifier.ris TY - Journal Article AU - Tadyanemhandu, Cathrine AU - Mukombachoto, Rufaro AU - Nhunzvi, Clement AU - Kaseke, Farayi AU - Chikwasha, Vasco AU - Chengetanai, Samson AU - Manie, Shamila AB - Background: The burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge. The objective of the study was to determine the pulmonary complications developing after abdominal and thoracic surgery and the associated risks factors. Methods: A retrospective records review of all abdominal and thoracic surgery patients admitted at a central hospital from January 2014 to October 2014 was done. Data collected included demographic data, surgical history, comorbidities and the PPCs present. Results: Out of the 92 patients whose records were reviewed, 55 (59.8%) were males and 84 (91.3%) had abdominal surgery. The mean age of the patients was 42.6 years (SD = 18.4). The common comorbidities were HIV infection noted in 14(15.2%) of the patients and hypertension in 10 (13.0%). Thirty nine (42.4%) developed PPCs and the most common complications were nosocomial pneumonia in 21 (22.8%) patients, ventilator associated pneumonia in 11 (12.0%), and atelectasis in 6 (6.5%) patients. Logistic regression showed that a history of alcohol consumption, prolonged surgery, prolonged stay in hospital or critical care unit, incision type, and comorbidities were significant risk factors for PPCs (p < 0.05). The mortality rate was 10.9%. Conclusion: PPCs like nosocomial and ventilator associated pneumonia were common and were associated with increased morbidity and adversely affected clinical outcomes of patients. HIV and hypertension presented significant comorbidities which the health team needed to recognize and address. Strategies to reduce the occurrence of PPCs have to be implemented through coordinated efforts by the health practitioners as a team during the entire perioperative period. DA - 2017-08-22 DB - OpenUCT DO - 10.1186/s13741-017-0066-3 DP - University of Cape Town J1 - Perioperative Medicine LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study TI - The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study UR - http://hdl.handle.net/11427/25040 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s13741-017-0066-3
dc.identifier.urihttp://hdl.handle.net/11427/25040
dc.identifier.vancouvercitationTadyanemhandu C, Mukombachoto R, Nhunzvi C, Kaseke F, Chikwasha V, Chengetanai S, et al. The prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study. Perioperative Medicine. 2017; http://hdl.handle.net/11427/25040.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Health and Rehabilitation Sciencesen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourcePerioperative Medicine
dc.source.urihttps://perioperativemedicinejournal.biomedcentral.com/
dc.subject.otherAbdominal surgery
dc.subject.otherThoracic surgery
dc.subject.otherPost-operative complications
dc.subject.otherPulmonary complications
dc.subject.otherHIV infection
dc.subject.otherComorbidities
dc.titleThe prevalence of pulmonary complications after thoracic and abdominal surgery and associated risk factors in patients admitted at a government hospital in Harare, Zimbabwe-a retrospective study
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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