According to one study, patients with the following diagnoses chronic obstructive pulmonary disease (COPD) were 61% more likely to die in the year following surgery and had 13% more postoperative medical costs compared to patients without COPD.
“Patients with COPD are often frail and have many health problems, so pre- and post-operative management should address all health problems, not just COPD. Unity Health Toronto site and University of Toronto said: statement.
In this retrospective, population-based cohort study, we examined postoperative long-term survival and health care costs in patients with COPD compared with patients without COPD. The result is Canadian Medical Association Journal (CMAJ).
Researchers identified a total of 932,616 patients aged 35 and over living in Ontario, Canada. Between 2005 and 2019, these patients underwent certain moderate-to-high-risk elective non-cardiac surgeries, including total hip or knee replacement, gastrointestinal surgery.Vascular surgery, etc.
Researchers followed participants for one year after surgery to assess survival and medical costs. Sociodemographic factors were incorporated into the analysis. Vulnerability, cancer, and procedure type modified the association between COPD and outcome.
In previous estimates, More than 10% of surgical patients have COPDOf all patients identified in this study, approximately 1 in 5 (170,482) had COPD. These patients tend to be older (62-78 years), male, frail, low-income, and have pre-existing conditions such as coronary artery disease. DiabetesWhen lung cancer.
COPD patients were 61% more likely to die (n = 5873, 3.4%) Patients without COPD (n = 9429, 1.2%) within 1 year after surgery. COPD had a partially adjusted hazard ratio (HR = 1.61; 95% CI, 1.58-1.64) and a fully adjusted hazard ratio (HR = 1.26; 95% CI, 1.24-1.29).
In addition, 52,021 (5.6%) patients died in the year following surgery, including 18,007 (10.6%) with COPD and 34,014 (4.5%) without COPD.
In addition, COPD was associated with a 13.1% (95% CI, 12.7%–13.4%) relative increase in partially adjusted health care costs, and a 4.6% (95% CI, 4.3%–5.0%) fully adjusted ) was associated with an increase in .
The researchers acknowledged that identifying patients who underwent surgery could bias the results and advocated further research to measure and define severe COPD in patients.
Overall, this study suggests that patients with COPD have a higher risk of death within 1 year after surgery and higher medical costs. Moreover, the greater risks and costs associated with COPD have been found to extend well beyond the 30-day perioperative period, and are influenced by frailty, cancer, and type of surgery, with COPD It suggests that patient postoperative care should be better managed. .
“People with COPD typically have concurrent comorbidities, biopsychosocial problems, and frailty,” the researchers wrote. “Our findings highlight the importance of careful risk assessment and decision making for her COPD patient considering surgery.”
reference
Sankar A, Thorpe K, McIsaac DI, Luo J, Wijeysundera DN, Gershon AS. Survival and health care costs after elective surgery: a comparison of patients with and without chronic obstructive pulmonary disease. Journal of the Canadian Medical Association. 2023; 195(2). doi:10.1503/cmaj.220733
