Acute exacerbation of idiopathic interstitial pneumonia after nonpulmonary surgery under general anesthesia: a retrospective study

Background: Idiopathic interstitial pneumonia (IIP) is associated with increased risk of acute exacerbation after lung surgery, which has a poor prognosis and can be fatal. Although some studies have investigated acute exacerbation of IIP after lung surgery, the incidence and risks of acute exacerbation of IIP after nonpulmonary surgery have not been reported. The aim of present study to evaluate the characteristics and risk factors for acute exacerbation of IIP after nonpulmonary surgery. Methods: We retrospectively reviewed the clinical characteristics of 2908 consecutive patients (1620 men, 1288 women; mean age, 61.7) who underwent nonpulmonary surgery under general anesthesia between April 2008 to April 2013. Using preoperative chest computed tomography images, we identified IIP cases and compared preoperative characteristics, laboratory findings, and anesthesia conditions among patients who did and did not develop AE. Results: We extracted 103 IIP patients who underwent nonpulmonary surgery; postoperative acute exacerbation of IIP developed in 8 (7.8%). Univariate analysis identified several risk factors, namely, emergency surgery, preoperative prednisolone use, high serum C-reactive protein, lactate dehydrogenase, white blood cell count, low serum albumin and propofol use during anesthesia. Conclusion: The results suggest that the incidences of postoperative acute exacerbation of IIP are similar after nonpulmonary and pulmonary surgery. In addition, propofol use during anesthesia is a possible risk factor for acute exacerbation of IIP after nonpulmonary surgery. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 156-164)