Pulmonary Function Tests for the Prediction of Postoperative Pulmonary Complications
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Pulmonary Function Tests for the Prediction of Postoperative Pulmonary Complications : A Systematic Review. / Dankert, Andre; Dohrmann, Thorsten; Löser , Benjamin ; Zapf, Antonia; Zöllner, Christian; Petzoldt, Martin.
in: DTSCH ARZTEBL INT, Jahrgang 119, Nr. 7, 18.02.2022, S. 99-106.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Pulmonary Function Tests for the Prediction of Postoperative Pulmonary Complications
T2 - A Systematic Review
AU - Dankert, Andre
AU - Dohrmann, Thorsten
AU - Löser , Benjamin
AU - Zapf, Antonia
AU - Zöllner, Christian
AU - Petzoldt, Martin
PY - 2022/2/18
Y1 - 2022/2/18
N2 - Background: Pulmonary function tests (PFTs) such as spirometry and blood gas analysis have been claimed to improve preoperative risk assessment. This systematic review summarizes the available scientific literature regarding the ability of PFTs to predict postoperative pulmonary complications (PPC) in nonthoracic surgery.Methods: We systematically searched MEDLINE, CINAHL, and the Cochrane Library for pertinent original research articles (PROSPERO CRD42020215502), framed by the PIT-criteria (PIT, participants, index test, target conditions), respecting the PRISMA-DTA recommendations (DTA, diagnostic test accuracy).Results: 46 original research studies were identified that used PFT-findings as index tests and PPC as target condition. QUADAS-2 quality assessment revealed a high risk of bias regarding patient selection, blinding, and outcome definitions. Qualitative synthesis of prospective studies revealed inconclusive study findings: 65% argue for and 35% against preoperative spirometry, and 43% argue for blood gas analysis. A (post-hoc) subgroup analysis in prospective studies with low-risk of selection bias identified a possible benefit in upper abdominal surgery (three studies with 959 participants argued for and one study with 60 participants against spirometry).Conclusion: As the existing literature is inconclusive it is currently unknown if PFTs improve risk assessment before nonthoracic surgery. Spirometry should be considered in individuals with key indicators for chronic obstructive pulmonary disease (COPD) scheduling for upper abdominal surgery.
AB - Background: Pulmonary function tests (PFTs) such as spirometry and blood gas analysis have been claimed to improve preoperative risk assessment. This systematic review summarizes the available scientific literature regarding the ability of PFTs to predict postoperative pulmonary complications (PPC) in nonthoracic surgery.Methods: We systematically searched MEDLINE, CINAHL, and the Cochrane Library for pertinent original research articles (PROSPERO CRD42020215502), framed by the PIT-criteria (PIT, participants, index test, target conditions), respecting the PRISMA-DTA recommendations (DTA, diagnostic test accuracy).Results: 46 original research studies were identified that used PFT-findings as index tests and PPC as target condition. QUADAS-2 quality assessment revealed a high risk of bias regarding patient selection, blinding, and outcome definitions. Qualitative synthesis of prospective studies revealed inconclusive study findings: 65% argue for and 35% against preoperative spirometry, and 43% argue for blood gas analysis. A (post-hoc) subgroup analysis in prospective studies with low-risk of selection bias identified a possible benefit in upper abdominal surgery (three studies with 959 participants argued for and one study with 60 participants against spirometry).Conclusion: As the existing literature is inconclusive it is currently unknown if PFTs improve risk assessment before nonthoracic surgery. Spirometry should be considered in individuals with key indicators for chronic obstructive pulmonary disease (COPD) scheduling for upper abdominal surgery.
KW - Humans
KW - Postoperative Complications/diagnosis
KW - Prospective Studies
KW - Pulmonary Disease, Chronic Obstructive/complications
KW - Respiratory Function Tests/adverse effects
KW - Spirometry/adverse effects
UR - https://pubmed.ncbi.nlm.nih.gov/34939921/
U2 - 10.3238/arztebl.m2022.0074
DO - 10.3238/arztebl.m2022.0074
M3 - SCORING: Review article
C2 - 34939921
VL - 119
SP - 99
EP - 106
JO - DTSCH ARZTEBL INT
JF - DTSCH ARZTEBL INT
SN - 1866-0452
IS - 7
ER -