ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
This article is part of the Research TopicPerioperative Management and Clinical Challenges in Elderly Major Surgical PatientsView all 4 articles
Postoperative Outcomes in Patients with COPD Undergoing Elective Non-Cardiac Surgery: A Propensity Score-Matched Cohort Study
Provisionally accepted
Levan B Berikashvili1Mariya M Shemetova1Mikhail Ya Yadgarov1Kristina K Kadantseva1Petr A Polyakov1
Alexey A Yakovlev1Andrey G Yavorovskiy2
Valery Likhvantsev3*- 1FGBNU Federal'nyj naucno-kliniceskij centr reanimatologii i reabilitologii, Lytkino, Russia
- 2Pervyj Moskovskij gosudarstvennyj medicinskij universitet imeni I M Secenova, Moscow, Russia
- 3Research Institute General Resuscitation im.V.A.Negovskogo, Moscow, Russia
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Background: Given the nature and pathophysiology of chronic obstructive pulmonary disease (COPD), it is reasonable to hypothesize that concomitant COPD may adversely affect clinical outcomes, leading to higher incidence of respiratory infections, prolonged mechanical ventilation, and prolonged hospital stay. However, robust evidence to support this assumption remains limited. The objective of this study was to evaluate the impact of chronic obstructive pulmonary disease (COPD) on postoperative outcomes in adult patients undergoing elective non-cardiac surgery. Methods: This retrospective cohort study analyzed data from the eICU Collaborative Research Database (eICU-CRD), including adult patients admitted to the ICU following elective non-cardiac surgery. Propensity score matching (PSM) was performed to adjust for confounding variables between COPD and non-COPD groups. Matching was based on age, sex, BMI, APACHE IV score, surgery type, and comorbidities. Post-matching outcomes included mortality, ICU/hospital length of stay, need for mechanical ventilation (MV), and postoperative lab parameters. Results: A total of 15,429 patients were included, with 1,720 (11.1%) having COPD. After PSM, 563 patients remained in each group. No significant differences were found in hospital (4.6% vs. 5.5%, p = 0.6) or ICU mortality (1.8% vs. 3.6%, p = 0.09). COPD patients had longer hospital stays (mean difference 1 day, p = 0.03) and a higher incidence of MV (35.9% vs. 27.7%, p = 0.003). Conclusion: Patients with chronic obstructive pulmonary disease (COPD) undergoing surgery demonstrate comparable ICU and hospital mortality rates to those without COPD. However, they tend to experience a longer hospital stay and require prolonged mechanical ventilation postoperatively.
Keywords: COPD, Elective Surgical Procedure, non-cardiac anesthesia, Hospital Mortality, Hospital stay, ICU mortality, ICU length of stay
Received: 05 Jun 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Berikashvili, Shemetova, Yadgarov, Kadantseva, Polyakov, Yakovlev, Yavorovskiy and Likhvantsev. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Valery Likhvantsev, lik0704@gmail.com
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