ASSESSMENT OF PREOPERATIVE PULMONARY FUNCTIONS TO REDUCE INTRA OPERATIVE COMPLICATIONS

Abstract

Background: Postoperative pulmonary complications (PPCs) remain a significant contributor to perioperative morbidity and mortality, particularly in patients with pre-existing respiratory conditions. Risk factors such as smoking history, respiratory diagnoses, and limited patient awareness of intraoperative risks further exacerbate surgical outcomes. Accurate identification of high-risk patients and the use of individualized preoperative strategies—including pulmonary function evaluation and patient education—can substantially reduce the incidence of PPCs and improve perioperative safety.

Objective: To identify the relationship between smoking history, type of respiratory condition, diagnostic test selection, and intraoperative pulmonary risk awareness in determining the occurrence of PPCs, and to propose evidence-based strategies for personalized respiratory risk management.

Methods: A cross-sectional study was conducted at Gulab Devi Hospital, Lahore, involving 286 elective surgery patients aged 45–65 years with pre-existing respiratory conditions such as COPD, asthma, obstructive sleep apnea (OSA), and pulmonary hypertension. Data were collected through patient questionnaires and clinical records. Chi-square tests and cross-tabulation analyses were used to assess associations among variables including smoking status, diagnostic testing, risk awareness, and postoperative outcomes.

Results: A statistically significant association (p = 0.018) was observed between smoking history and type of respiratory illness: COPD and pulmonary hypertension were more prevalent in former smokers, while asthma was common among current smokers. Pulmonary function tests (PFTs) were the preferred diagnostic modality in 217 out of 286 patients (75.9%), significantly correlated with the type of respiratory condition (p = 0.000). Notably, 100% of the 76 patients educated on intraoperative pulmonary risks developed no PPCs, compared to 71.4% complication incidence in uneducated groups (p = 0.000).

Conclusion: The study highlights the critical role of smoking history, diagnostic selection, and patient education in predicting and preventing PPCs. Implementation of individualized preoperative protocols incorporating targeted assessments and informed counseling is essential for optimizing surgical outcomes.