Evaluation of thoracic surgery patients with integrated pulmonary index postoperatively

Objective: The aim of this study is to investigate the effect of postoperative integrated pulmonary index (IPI) scores on postoperative complications, mortality and morbidity in the patients undergoing thoracic surgery. Material and Methods: A total of 97 patients, who had ASA I-III class, 18 years and older, undergone elective thoracotomy and video-assisted thoracic surgery (VATS), volunteer to participate study, between 01.08.2020 and 31.01.2021, were included in the study. Systolic, diastolic and mean arterial blood pressures, SpO2, EtCO2, pulse rate, respiratory rate, IPI scores and arterial blood gas analysis were evaluated at the postoperative recovery unit at 15th and 30th minutes, 1th and 2th hours, postoperatively. All patients were visited at the 6th, 12th, 18th and 24th hours after surgery. Systolic, diastolic, mean arterial blood pressure, pulse rate, respiratory rate, oxygen saturation and arterial blood gas analysis, the need of intensive care, length of hospital stay, possible complications and 28-days mortality were recorded. Results: The mean of age of the 97 patients included in the study was 50,26 ± 16,3, the percentage of the male patients were 58,8% while the female patients were 41,2%. The percentage of ASA I patients were 32%, where as the patients with ASA II score were 68%. The percentage of operation with VATS procedure was 70,1%, 46,4% of them were right VATS and 23,7% of them were left VATS. While the percentage of the operation with thoracotomy was 29,9%, 20,6% of them were right thoracotomy and 9,3% of them were left thoracotomy. The mean duration of anesthesia was 135,7 ± 47,3 minutes while the mean duration of surgery was 113,2 ± 44,5 minutes. Postoperatively, the mean IPI scores of the patients were 8,1 + 1,3 at the first 15 minutes and 8,7 + 1,1 at the first 30 minutes. During the postoperative 28-day follow up, postoperative complications were detected in 30,9% of the patients. The mean of discharge from the hospital was 5,63 + 4,5 days. A statistically significant correlation was found between arterial blood gas pH values and postoperative IPI scores, comorbidity and postoperative IPI scores, ASA scores and postoperative IPI scores. However, no statistically significant correlation was found between other parameters and postoperative IPI scores. Conclusion: According to the data obtained from our study, IPI score is a simple and safe noninvasive monitoring method that can be used in early patient follow-up after thoracic surgery. We believe that the use of IPI monitors compared to standard clinical care in the postoperative patients may lead to earlier detection of possible respiratory complications, increase of nurse interventions in the recovery rooms and therefore decrease in mortality and morbidity. Key words: integrated pulmonary index, monitoring, postoperative complications, thoracic surgery