Factors associated with immediate postoperative pulmonary complications after Appendectomies under general anesthesia: A retrospective analysis

Background: Postoperative pulmonary complications (PPC) include any complication that affects the respiratory system after anesthesia and surgery and are a significant cause of postoperative mortality and morbidity.

Objectives: To describe the risk factors for immediate postoperative pulmonary complications after appendectomy under general anesthesia and to determine if rapid sequence induction decreases the risk.

Design and setting: A retrospective analysis of perioperative medical records of patients who underwent appendectomy under general anesthesia over a year, from January 1st, 2014, to December 31st, 2014, at Hamad General Hospital, Doha, Qatar, was done.

Results: Of the 1005 patients who met the inclusion criteria, 27 (3.7%) had PPC. The incidence of PPC had a significant positive association with diabetes mellitus (DM), bronchial asthma (BA), number of intubation attempts, laparoscopic approach, and longer surgeries (>2 h). Hypertension, recent or ongoing upper respiratory tract infections, and smoking were not associated with an increased risk of PPC. Non-rapid sequence intubation (RSI) was not associated with an increased risk of PPC compared with RSI.

Conclusions: The incidence of immediate PPC in ASA 1 and 2 appendectomy patients aged between 15 and 50 is significant. There is an increased risk among asthmatics, diabetics, and those with difficult airways. The RSI technique does not offer protection.