Predictors of Postoperative Pulmonary Complications Following Abdominal Surgery

Abstract

To determine how risk factors could be combined to best predict the development of a postoperative pulmonary complication (PPC) following abdominal surgery. Prospective model-building study. Logistic regression models were developed using significant risk factors identified in the univariate analysis. Four midwestern hospitals. Convenience sample of 400 patients who underwent abdominal surgical procedures between January 1993 and August 1995. Multicriteria outcome for postoperative pulmonary complication used to collectively assess atelectasis and pneumonia. Twenty-three risk factors were assessed. Six risk factors were identified as independent by logistic regression: age > or = 60 years (adjusted odds ratio [Adj OR], 1.89); impaired preoperative cognitive function (Adj OR, 5.93); smoking history within the past 8 weeks (Adj OR, 2.27); body mass index > or = 27 (Adj OR, 2.82); history of cancer (Adj OR, 2.23); and incision site-upper abdominal or both upper/lower abdominal incision (Adj OR 2.30). These results provide a framework for identifying patients at risk of developing a PPC following abdominal surgery. A reliable and valid risk index could be used clinically to guide preoperative and postoperative pulmonary care and target limited resources for patients at risk.