Predictability of pulmonary function tests for intra- and post-operative cardiopulmonary complications of corrective surgery to treat scoliosis: a retrospective study.

Kang,  Gi Run; Lee,  Il Ok

doi:2009.57.5.590

Original Article

Korean Journal of Anesthesiology 2009;57(5):590-596.
DOI: https://doi.org/10.4097/kjae.2009.57.5.590

Predictability of pulmonary function tests for intra- and post-operative cardiopulmonary complications of corrective surgery to treat scoliosis: a retrospective study.

Gi Run Kang, Il Ok Lee

Department of Anesthesiology and Pain Medicine, College of Medicine, Korea University, Guro Hospital, Seoul, Korea. iloklee@korea.ac.kr

Abstract

BACKGROUND
This study was conducted to confirm the predictive power of preoperative pulmonary functions tests (PFTs) for intra- and post-operative cardiopulmonary complications during corrective surgery for scoliosis.
METHODS
A retrospective review of hospital charts of patients who underwent surgical correction for scoliosis and/or kyphosis at our medical center between September 2002 and September 2008 was performed.
RESULTS
A total of 141 patients were enrolled in this study. The overall intra- and post-operative cardiopulmonary complication rate was 33.3% (47/141). There were 32 and 19 complications related to pulmonary issues (22.7%) and cardiovascular complications (13.5%), respectively. The complication rate of neuromuscular scoliosis (NMS) was 47.3% (35/74), while that of non-neuromuscular scoliosis (NNMS) was 17.9% (12/67). The cardiopulmonary complication rates of groups with FEV1 volumes below 1 L, 1-1.5 L, 1.5-2 L and over 2 L were 66.7% (18/27), 43.3% (13/30), 20.0% (7/35) and 18.4% (9/49), respectively. The group with FEV1 volumes below 1 L showed a significantly increased risk when compared to the group with FEV1 volumes over 2 L (P<0.05, Odds ratio = 5.15, multivariate logistic regression test). The cardiopulmonary complication rates of groups with FVC volumes below 1 L, 1-1.5 L, 1.5-2 L and over 2 L were 70.8% (17/24), 37.5% (9/24), 33.3% (11/33) and 16.7% (10/60), respectively. Additionally, the group with FVC volumes below 1 L showed significantly increased risk when compared to a group with FVC volumes greater than 2 L (P<0.001, Odds ratio = 8.0, multivariate logistic regression).
CONCLUSIONS
The correction for NMS carries a higher complication rate than NNMS. Intra- and post-operative cardiopulmonary complication rates of a group with FEV1 or FVC volumes below 1 L were higher than the rates of groups with FEV1 and FVC volumes greater than 2 L.

Key Words: Intraoperative complications; Postoperative complications; Pulmonary function tests; Risk factors; Scoliosis