Epidemiology and risk of pulmonary complications following hepatobiliary surgical procedures: A retrospective study

Table 1 Incidence of postoperative pulmonary complications in this study

PPCs	n	Ratio (n/total number of patients),%
Pleural effusion	41	52.56%
Respiratory infection	34	43.59%
Respiratory failure	10	12.82%
Atelectasis	10	12.82%
Pneumothorax	2	2.56%
Bronchospasm	1	1.28%
Aspiration pneumonia	0	0

PPCs: Postoperative pulmonary complications.

Table 2 Comparison of baseline characteristics between the non-postoperative pulmonary complication and postoperative pulmonary complication groups, n (%)

Variable	PPC (n = 78)	Non-PPC (n = 234)	P value
Demographics
Sex (male)	56 (71.2)	145(62.0)	0.116
Age (years)	59 (24-90)	56 (23-87)	0.03
Height (cm)	167 (145-185)	167 (150-185)	0.663
Weight (kg)	63 (36.5-95)	64 (37-99)	0.688
BMI (kg/m2)	22.6 (16.22, 34.67)	23.0 (14.6, 38.11)	0.279
Preoperative status
Smoking	8 (10)	26 (11)	0.834
Pathogenic colonization bacteria	11 (14.1)	18 (7.7)	0.091
Hemoglobin, mean ± SD	144.49 ± 23.13	119.68 ± 24.61	0.102
Platelet, mean ± SD	180.53 ± 86.59	196.06 ± 100.36	0.222
Albumin (g/L), mean ± SD	34.30 ± 5.52	37.88 ± 6.71	< 0.001
TBIL (μmol/L)	17.75 (4.0-504.9)	13.8 (2.5-476.3)	0.038
DBIL (μmol/L)	11.4 (1.7-507)	6.6 (1.6-401.2)	0.002
AST (U/L)	43.35 (10.10-3421.10)	29 (9.4-3435.4)	0.002
ALT (U/L)	41.95 (5.6-1617.4)	24.8 (5.0-2004.9)	0.003
Comorbidities
Hypertension	24 (30.8)	62 (26.5)	0.464
Diabetes mellitus	0	29 (12.4)	0.001
HBV infection	18 (23.1)	48 (20.5)	0.631
Liver cirrhosis	10 (12.8)	40 (17.1)	0.373
Heart failure	1 (1.3)	2 (0.9)	0.738
History of stroke	1 (1.3)	13 (5.5)	0.114
COPD	0	5 (2.13)	0.193

PPC: Postoperative pulmonary complication; BMI: Body mass index; TBIL: Total bilirubin; DBIL: Direct bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HBV: Hepatitis B virus; COPD: Chronic obstructive pulmonary disease.

Table 3 Intraoperative and postoperative factors in the non-postoperative pulmonary complication and postoperative pulmonary complication groups, n (%)

Variable	PPC (n = 78)	Non-PPC (n = 234)	P value
Intraoperative factors
ASA physical status
III-IV	34 (43.59)	51 (21.8)	< 0.001
Operation duration ≥ 2 hours	45 (57.7)	78 (33.3)	< 0.001
Anesthesia duration (10 minutes)	572.18 ± 226.41	252.98 ± 222.71	< 0.001
Estimated blood loss ≥ 100 mL	38 (48.7)	38(16.2)	< 0.001
Blood transfusion	19 (24.4)	11 (4.7)	< 0.001
Infusion (mL)	4550.16 ± 2239.36	2320.70 ± 1957.34	< 0.001
Surgical procedure
Interventional surgery (percutaneous arterial embolization/angiography/catheterization)	34 (43.6)	110 (47.0)	0.6
Liver surgery (liver segment/partial resection)	25 (32.1)	76 (32.48)	0.944
Laparoscopic surgery (gallbladder/Liver/intestine)	8 (10.25)	29 (12.39)	0.613
Other operations	7 (9.0)	15 (6.4)	0.444
Pancreatic surgery	4 (5.1)	4 (1.7)	0.098
Postoperative factors
Pain (NRS score ≥ 1)	1 (1.3)	13 (5.5)	0.114
Poor drainage	1 (1.3)	0	0.083

PPC: Postoperative pulmonary complication; ASA: American Society of Anesthesiologists; NRS: Numeric Rating Scale.

Table 4 Hospital length of stays and healthcare cost burden among patients

Group	All patients (n = 312)	LOS (days) [median (P25, P75)]	Postoperative hospital stays (days) [median (P25, P75)]	Total cost (10000 yuan)1 [median (P25, P75)]	Medication costs (10000 yuan)1 [median (P25, P75)]
PPCs	78	15 (8, 21)	11 (6, 17)	12.19 (5.34, 20.06)	2.25 (1.00, 4.96)
Non-PPCs	234	7 (4, 12)	3 (1, 7)	3.22 (2.02, 6.81)	0.75 (0.17, 1.63)
Z value	-	-5.957	-7.662	-7.044	-6.550
P value	-	< 0.001	< 0.001	< 0.001	< 0.001

¹All costs are Chinese Yuan, per 10 thousand Yuan.

PPCs: Postoperative pulmonary complications; LOS: Length of stays.