Sex dependence of postoperative pulmonary complications - A post hoc unmatched and matched analysis of LAS VEGAS.

General anaesthesia; Intraoperative ventilation; Operating room; Outcome; Postoperative pulmonary complications; Sex; Humans; Male; Female; Middle Aged; Sex Factors; Aged; Incidence; Respiration, Artificial/statistics & numerical data; Propensity Score; Adult; Risk Factors; Cohort Studies; Postoperative Complications/epidemiology; Postoperative Complications/etiology; Anesthesia, General/adverse effects; Length of Stay/statistics & numerical data; Lung Diseases/epidemiology; Lung Diseases/etiology; Anesthesia, General; Length of Stay; Lung Diseases; Postoperative Complications; Respiration, Artificial; Anesthesiology and Pain Medicine

Abstract :

[en] [en] STUDY OBJECTIVE: Male sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study' (LAS VEGAS) to evaluate differences between females and males with respect to PPCs. DESIGN, SETTING AND PATIENTS: Post hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs. MAIN RESULTS: The unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81-1.06]; P = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89-1.25]; P = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts. CONCLUSIONS: In this conveniently-sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes. REGISTRATION: LAS VEGAS was registered at clinicaltrial.gov (study identifier NCT01601223).

Disciplines :

Anesthesia & intensive care

Author, co-author :

Vermeulen, Tom D; Amsterdam University Medical Center, Department of Anaesthesiology, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands. Electronic address: t.d.vermeulen@amsterdamumc.nl

Hol, Liselotte; Amsterdam University Medical Center, Department of Anaesthesiology, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands

Swart, Pien; Amsterdam University Medical Center, Department of Intensive Care, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands

Hiesmayr, Michael; Medical University Vienna, Division Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care, Waehringerguertel 18-20, A-1090 Vienna, Austria

Mills, Gary H; Sheffield Teaching Hospitals, Sheffield and University of Sheffield, Operating Services, Critical Care and Anaesthesia, Royal Hallamshire Hospital, Broomhill, Glossop Road, Sheffield S10 2JF, United Kingdom

Putensen, Christian; University Hospital Bonn, Department of Anaesthesiology and Intensive Care Medicine, Venusberg-Campus 1, 53127 Bonn, Germany

Schmid, Werner; Medical University Vienna, Division Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care, Waehringerguertel 18-20, A-1090 Vienna, Austria, Medical University Vienna, Department of Special Anaesthesia and Pain Therapy, Waehringerguertel 18-20, A-1090 Vienna, Austria

Serpa Neto, Ary; Amsterdam University Medical Center, Department of Intensive Care, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands, Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Department of Critical Care Medicine, 553 St Kilda Road, Melbourne, VIC 3004, Australia, Hospital Israelita Albert Einstein, Department of Critical Care, Av. Albert Einstein, 627/701 - Morumbi, São Paulo, SP 05652-900, Brazil

Severgnini, Paolo; University of Insubria - ASST Sette Laghi, Anestesia Rianimazione Cardiologica, Department of Biotechnologies and Sciences of Life, Viale Borri, 57-21100 Varese, VA, Italy

Vidal Melo, Marcos F; Massachusetts General Hospital, Department of Anaesthesia, Critical Care and Pain Medicine, 15 Parkman St, MA 02114 Boston, MA, USA, Columbia University, Department of Anesthesiology, 622 W 168th St, NY 10032, New York, USA

More authors (9 more)

Other collaborator :

Lois, Fernande ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation

Language :

English

Title :

Sex dependence of postoperative pulmonary complications - A post hoc unmatched and matched analysis of LAS VEGAS.

Publication date :

December 2024

Journal title :

Journal of Clinical Anesthesia

ISSN :

0952-8180

Publisher :

Elsevier, United States

Volume :

Pages :

111565

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0952818024001946?httpAccept=text/xml

Funders :

ESA - European Society of Anaesthesiology

Funding text :

LAS VEGAS was endorsed and partly funded by a research grant from the European Society of Anaesthesiology through their Clinical Trial Network. There was no additional funding for this analysis.

Available on ORBi :

since 13 March 2025

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