• Chao-Shun Lin, Chuen-Chau Chang, Chun-Chieh Yeh, Chi-Li Chung, Ta-Liang Chen, and Chien-Chang Liao.
• From the Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan (CSL, CCC, TLC, CCL); Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan (CSL, CCC, TLC, CCL); Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (CSL, CCC, TLC, CCL); Department of Surgery, China Medical University Hospital, Taichung, Taiwan (CCY); Department of Surgery, University of Illinois, Chicago, USA (CCY); Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (CLC); School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan (CCL).
• Medicine (Baltimore). 2016 Jan 1; 95 (3): e2548.

AbstractOutcome after surgery in patients with asthma remains unknown. The purpose of this study is to investigate postoperative major complications and mortality in surgical patients with asthma.Using reimbursement claims from the Taiwan National Health Insurance Research Database, the authors identified 24,109 surgical patients with preoperative asthma and 24,109 nonasthma patients undergoing major surgeries using matching procedure with propensity score by sociodemographics, coexisting medical conditions, and surgical characteristics. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for 30-day postoperative complications and mortality associated with asthma were analyzed in the multivariate logistic regressions.Asthma increased postoperative pneumonia (OR 1.48; 95% CI 1.34-1.64), septicemia (OR 1.11; 95% CI 1.02-1.21), and urinary tract infection (OR 1.17; 95% CI 1.09-1.26). Preoperative emergency care for asthma was significantly associated with postoperative 30-day in-hospital mortality, with an OR of 1.84 (95% CI 1.11-3.04). Preoperative emergency service, hospitalizations, admission to intensive care unit, and systemic use of corticosteroids for asthma were also associated with higher postoperative complication rates for asthmatic patients.Postoperative complications and mortality were significantly increased in asthmatic patients. We suggest urgent efforts to revise protocols for asthma patients' perioperative care.

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