Evaluation of respiratory efficiency of patients qualified for surgery on the abdominal aorta

Background: Operations in the area of abdominal aorta generate huge stress for the patients, therefore proper estimation of the risk of postoperative complications is important for the outcome of treatment.

The aim of this study was to determine the level of respiratory efficiency before scheduled operations of patients suffering from aortic abdominal aneurysms (AAA) in comparison to patients suffering from Leriche syndrome (LS). The aim of the study was to assess the incidence of chronic obstructive pulmonary disease (COPD) in the two analyzed groups.

Material and methods: The research was conducted in a group of 105 males reporting consecutively for scheduled operations at the Vascular Surgery & Angiology ward of the St. John Grande Merciful Brothers’ Hospital in Cracow. The patients constituted two groups – patients of the first group suffered from abdominal aortic aneurysms (n = 66), whereas patients of the second group suffered from the Leriche syndrome

(n = 39). Attention was paid to the chronic pulmonary disorders in medical records. Body mass and height were measured, on the basis of which the BMI index was calculated. The period of smoking was calculated as pack years.

The patients were examined for respiratory efficiency which was determined on the basis of selected spirometry indicators.

Results: COPD was found in 31.8% of patients with AAA and 10.3% with LS. The difference was statistically relevant. Mean values of most of spirometry indicators did not differ between patients suffering from AAA and those suffering from LS (p > 0.05). It was proven that there is a difference as for the Tiffeneau index, which was higher in patients suffering from the Leriche syndrome (p = 0.004).

Conclusions: It has been claimed that most of patients qualified for scheduled operations in the area of abdominal aorta have decreased spirometry results comparing to normals (80%). The average levels of the spirometry results did not differ significantly for patients with Leriche syndrome and abdominal aortic aneurysm, except for the Tiffeneau index level, which was higher in patients suffering from the Leriche syndrome. That indicator is the key factor for recognizing chronic obstructive pulmonary disease. Moreover, there has been observed a higher incidence of COPD in patients with abdominal aortic aneurysm, than in those suffering from the Leriche syndrome.

Such results may suggest extraordinary presurgery preparation concerning pulmonary function in those patients.