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Multidisciplinary Intervention Cuts Post-Op Complications

Multidisciplinary Intervention Cuts Post-Op Complications

I COUGH emphasizes patient education, early mobilization, pulmonary interventions

FRIDAY, June 7 (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, M.D., 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 at least three 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 percent before the implementation of I COUGH and decreased to 1.6 percent 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 2.0 percent, and this decreased to 1.2 percent after implantation; risk-adjusted outcomes decreased from an observed-expected ratio of 2.10 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.

Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1693122#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1693122 )