Multidisciplinary Intervention Cuts Post-Op Complications
(HealthDay News) – For patients undergoing general or vascular surgery, implementation of a multidisciplinary pulmonary care program (I COUGH) correlates with reduced incidence of postoperative pneumonia and unplanned intubation, according to a study published online June 5 in JAMA Surgery.
Michael R. Cassidy, MD, from Boston University Medical Center, and colleagues examined the efficacy of I COUGH for reducing postoperative pulmonary complications. The program emphasizes incentive spirometry, coughing and deep breathing, oral care, patient and family education, getting out of bed ≥3 times a day, and head-of-bed elevation. Pulmonary outcomes were compared for patients who underwent general or vascular surgery during a one-year period before and after implementation of I COUGH in August 2010.
The researchers found that the incidence of postoperative pneumonia was 2.6% before the implementation of I COUGH and decreased to 1.6% after its implementation. The risk-adjusted outcomes decreased from an observed-expected ratio of 2.13 before implementation to an odds ratio of 1.58 after implementation. Before I COUGH, the incidence of unplanned intubations was 2%, and this decreased to 1.2% after implantation; risk-adjusted outcomes decreased from an observed-expected ratio of 2.1 before implementation to an odds ratio of 1.31 after implementation.
"I COUGH, a standardized postoperative care program emphasizing patient education, early mobilization, and pulmonary interventions, reduced the incidence of postoperative pneumonia and unplanned intubation among our patients," the authors write.
I COUGH is a registered service mark of Boston Medical Center Corporation.