Trends in Pulmonary Complications after Major Abdominal Surgery

1Laredo Medical Center, Laredo, TX

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 49


Pulmonary complications following abdominal surgery are a major cause of morbidity, mortality, and prolonged hospitalization. Despite this, there is scarce information about national trends in postoperative pulmonary complications.


The National Hospital Discharge Survey (NHDS) was used to generate estimates of selected abdominal operations and postoperative pulmonary complications. The population at risk included all patients at least 18 years old who underwent abdominal surgery between 1989 and 2004 and had any of these ICD‐9‐CM procedure codes: 41.5 (splenectomy), 43.5x (gastrectomy), 44.0x (vagotomy), 45.7x (partial excision of large intestine), 45.8 (total colectomy), 47.0x (appendectomy), 48.5 (abdominal perineal resection of rectum), 51.2x (cholecystectomy), 52.7 (radical pancreaticoduodenectomy), and 54.11 (exploratory laparatomy). Postoperative pulmonary complications were defined as pneumonia (480‐6) atelectasis (518.0), respiratory failure (518.8x), ARDS (518.5), and pleural effusion (511.x). The Mantel‐Haenszel test for trend was used to analyze the proportion of postoperative pulmonary complications following abdominal surgery over 4 periods (1989‐1992, 1993‐1996, 1997‐2000, and 20012004) stratified by sex and age groups.


An estimated 12,897,800 major abdominal operations were performed in the United States between 1989 and 2004. There were postoperative pulmonary complications after the surgeries of 388,400 men (7.8%), mean age 63 ± 16.9 years, and 452,800 women (5.7%), mean age 65 ± 17.2 years. Postoperative pulmonary complications were also associated with lengthy hospitalization. In this study, mean hospital stay was 16 ± 18.1 days for patients with pulmonary complications compared with 6 ± 8.5 days for those without complications. A total of 155,300 men (3.1%) and 152,800 women (1.9%) died during hospitalization after abdominal surgery. However, the case‐fatality rates of men (1.0 vs. 2.1) and women (0.7 vs. 1.3) with pulmonary complications remain relatively low.

The proportion of pulmonary complications increased exponentially with age and was higher in men than in women. Furthermore, trend analysis showed that pulmonary complication rates increased significantly over the study period for all age groups except men < 45 years old and men 45‐64 years old (Table 1).

TABLE 1. Estimated Number (%) of Pulmonary Complications following Major Abdominal Surgery


The results of this study indicate that the number of pulmonary complications following major abdominal surgery increased in the United States between 1989 and 2004. Further research is needed to identify the independent association of abdominal operations with postoperative pulmonary complications.

Author Disclosure:

C. H. Orces, None.

To cite this abstract:

Orces C. Trends in Pulmonary Complications after Major Abdominal Surgery. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 49. Journal of Hospital Medicine. 2007; 2 (suppl 2). Accessed April 10, 2020.

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