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The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan

BACKGROUND: Postoperative pulmonary complications can be a major catastrophic consequence of major surgeries and can lead to increased morbidity, mortality, hospital stay, and cost. Many protocols have been tried to reduce serious adverse outcomes with effective strategies including a bundle of preo...

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Autores principales: Abdel Jalil, Riad, Al-Najjar, Hani, Abou Chaar, Mohamad K., Al-Masri, Mahmoud, Daoud, Faiez, Al-Ebous, Ali, Dabous, Ali, Shehadeh, Ahmad M., Abdel Al, Samer, Alawneh, Fade, Al-Qudah, Obada, Al-Kharabsheh, Mohammad, Al-Odat, Ghazi, Mohammad, Iqbal, Hussein, Najah, Hudaip, Zeinab, Al-Tbakhi, Asma, Aqel, Flsteen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788896/
https://www.ncbi.nlm.nih.gov/pubmed/33407717
http://dx.doi.org/10.1186/s13037-020-00277-z
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author Abdel Jalil, Riad
Al-Najjar, Hani
Abou Chaar, Mohamad K.
Al-Masri, Mahmoud
Daoud, Faiez
Al-Ebous, Ali
Dabous, Ali
Shehadeh, Ahmad M.
Abdel Al, Samer
Alawneh, Fade
Al-Qudah, Obada
Al-Kharabsheh, Mohammad
Al-Odat, Ghazi
Mohammad, Iqbal
Hussein, Najah
Hudaip, Zeinab
Al-Tbakhi, Asma
Aqel, Flsteen
author_facet Abdel Jalil, Riad
Al-Najjar, Hani
Abou Chaar, Mohamad K.
Al-Masri, Mahmoud
Daoud, Faiez
Al-Ebous, Ali
Dabous, Ali
Shehadeh, Ahmad M.
Abdel Al, Samer
Alawneh, Fade
Al-Qudah, Obada
Al-Kharabsheh, Mohammad
Al-Odat, Ghazi
Mohammad, Iqbal
Hussein, Najah
Hudaip, Zeinab
Al-Tbakhi, Asma
Aqel, Flsteen
author_sort Abdel Jalil, Riad
collection PubMed
description BACKGROUND: Postoperative pulmonary complications can be a major catastrophic consequence of major surgeries and can lead to increased morbidity, mortality, hospital stay, and cost. Many protocols have been tried to reduce serious adverse outcomes with effective strategies including a bundle of preoperative, intraoperative and postoperative techniques. Using these techniques maybe challenging in developing countries with limited resources even in specialized centers. METHODS: A before-and-after trial comparing our data from the national surgical quality improvement program (NSQIP) based on their reports. Data was collected prospectively for the patients who underwent major surgeries at King Hussein Cancer Center during the year 2017 when the use of the perioperative pulmonary care bundle was mandatory to all surgery teams and compared it with the data collected retrospectively for the patients who underwent the same type of surgeries in the year 2016 when the use of such a bundle was optional. The primary end point is the decrease in incidence of postoperative pulmonary complications. Simple descriptive statistical analysis was used to obtain results. RESULTS: The potential risk factors for postoperative pulmonary complications for 1665 patients divided into 2 groups (2016 vs. 2017); 764 (45.9%) vs. 901 (54.1%), respectively. There were no significant differences regarding gender (male 46.7% vs. 46.4%, P value = 0.891, female 53.3% vs. 53.6%, P value = 0.39), mean of age (53.5 year vs. 5.28 year, P value = 0.296), mean of body mass index (BMI) (28.6 vs. 6%, 28.6, P value = 0.95), smoking status; (69.6% vs. 65.1%, P value = 0.052), ventilator use (0.3% vs. 0.4% P value = 0.693) and chronic obstructive pulmonary disease (1.4% vs. 1.4 with, P value = 0.996).The data showed a significant reduction in postoperative pneumonia between the 2 groups (2016 vs. 2017) (2.7% vs. 0.9%, P value = 0.004) and showed a significant reduction in unplanned intubation, 1.4% in 2016 vs. 0.7% in 2017. CONCLUSIONS: The standardization of perioperative pulmonary care bundle, including smoking cessation, perioperative pulmonary interventions and early mobilization, significantly reduces the incidence of postoperative pulmonary complications in cancer patients. This technique's implementation was feasible easily even with limited resources in a developing country like Jordan.
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spelling pubmed-77888962021-01-07 The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan Abdel Jalil, Riad Al-Najjar, Hani Abou Chaar, Mohamad K. Al-Masri, Mahmoud Daoud, Faiez Al-Ebous, Ali Dabous, Ali Shehadeh, Ahmad M. Abdel Al, Samer Alawneh, Fade Al-Qudah, Obada Al-Kharabsheh, Mohammad Al-Odat, Ghazi Mohammad, Iqbal Hussein, Najah Hudaip, Zeinab Al-Tbakhi, Asma Aqel, Flsteen Patient Saf Surg Research BACKGROUND: Postoperative pulmonary complications can be a major catastrophic consequence of major surgeries and can lead to increased morbidity, mortality, hospital stay, and cost. Many protocols have been tried to reduce serious adverse outcomes with effective strategies including a bundle of preoperative, intraoperative and postoperative techniques. Using these techniques maybe challenging in developing countries with limited resources even in specialized centers. METHODS: A before-and-after trial comparing our data from the national surgical quality improvement program (NSQIP) based on their reports. Data was collected prospectively for the patients who underwent major surgeries at King Hussein Cancer Center during the year 2017 when the use of the perioperative pulmonary care bundle was mandatory to all surgery teams and compared it with the data collected retrospectively for the patients who underwent the same type of surgeries in the year 2016 when the use of such a bundle was optional. The primary end point is the decrease in incidence of postoperative pulmonary complications. Simple descriptive statistical analysis was used to obtain results. RESULTS: The potential risk factors for postoperative pulmonary complications for 1665 patients divided into 2 groups (2016 vs. 2017); 764 (45.9%) vs. 901 (54.1%), respectively. There were no significant differences regarding gender (male 46.7% vs. 46.4%, P value = 0.891, female 53.3% vs. 53.6%, P value = 0.39), mean of age (53.5 year vs. 5.28 year, P value = 0.296), mean of body mass index (BMI) (28.6 vs. 6%, 28.6, P value = 0.95), smoking status; (69.6% vs. 65.1%, P value = 0.052), ventilator use (0.3% vs. 0.4% P value = 0.693) and chronic obstructive pulmonary disease (1.4% vs. 1.4 with, P value = 0.996).The data showed a significant reduction in postoperative pneumonia between the 2 groups (2016 vs. 2017) (2.7% vs. 0.9%, P value = 0.004) and showed a significant reduction in unplanned intubation, 1.4% in 2016 vs. 0.7% in 2017. CONCLUSIONS: The standardization of perioperative pulmonary care bundle, including smoking cessation, perioperative pulmonary interventions and early mobilization, significantly reduces the incidence of postoperative pulmonary complications in cancer patients. This technique's implementation was feasible easily even with limited resources in a developing country like Jordan. BioMed Central 2021-01-06 /pmc/articles/PMC7788896/ /pubmed/33407717 http://dx.doi.org/10.1186/s13037-020-00277-z Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Abdel Jalil, Riad
Al-Najjar, Hani
Abou Chaar, Mohamad K.
Al-Masri, Mahmoud
Daoud, Faiez
Al-Ebous, Ali
Dabous, Ali
Shehadeh, Ahmad M.
Abdel Al, Samer
Alawneh, Fade
Al-Qudah, Obada
Al-Kharabsheh, Mohammad
Al-Odat, Ghazi
Mohammad, Iqbal
Hussein, Najah
Hudaip, Zeinab
Al-Tbakhi, Asma
Aqel, Flsteen
The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title_full The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title_fullStr The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title_full_unstemmed The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title_short The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan
title_sort impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in jordan
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788896/
https://www.ncbi.nlm.nih.gov/pubmed/33407717
http://dx.doi.org/10.1186/s13037-020-00277-z
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