Pulmonary Complications After Open Abdominal Aortic Surgery: A Systematic Review and Meta-Analysis

L Pasin, Pasquale Nardelli, Alessandro Belletti, M Greco, G Landoni, L Cabrini, R Chiesa, A Zangrillo

Research output: Contribution to journalArticlepeer-review


Objectives: Postoperative pulmonary complications (PPC) are among the most common complications after noncardiac surgery. Men, smokers, and elderly patients with chronic obstructive pulmonary disease or heart failure are more likely to experience PPC. The majority of patients undergoing vascular surgery belong in these categories and are at higher risk of developing PPC. Moreover, the surgical site is one of the most important risk factors associated with PPC, and aortic surgery carries the highest risk. The aim of this systematic review was to obtain an additional understanding of the real incidence of PPC after open abdominal aortic surgery and the impact of PPC on survival. Design: Systematic review and meta-analysis. Setting: Hospitals. . Participants: Patients who underwent open abdominal aortic surgery. Interventions: None. Measurements and Main Results: A literature search was performed on BioMedCentral, PubMed, Embase, and the Cochrane Register of clinical trials. All prospective or retrospective studies reporting data on PPC after open abdominal aortic surgery were included. Co-primary endpoints were the PPC rate and the correlation between PPC and perioperative mortality. The secondary endpoint was the difference in the PPC rate and mortality between elective and urgent surgery. Data on 269,637 patients from 213 studies were analyzed. The overall median incidence of PPC was 10.3% (interquartile range 5.55%-19.1%). Pneumonia, respiratory insufficiency, prolonged mechanical ventilation, need for unplanned mechanical ventilation, atelectasis, acute respiratory distress syndrome, pulmonary edema, and pleural effusions were the most common PPC reported in the literature. Occurrence of PPC was associated with postoperative mortality (r = 0.65, p
Original languageEnglish
Pages (from-to)562-568
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number2
Publication statusPublished - 2017


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