PREDICTORS OF POSTOPERATIVE PULMONARY COMPLICATIONS FOLLOWING ABDOMINAL-SURGERY

Study objective: To determine how risk factors could be combined to be st predict the development of a postoperative pulmonary complication ( PPC) following abdominal surgery. Design: Prospective model-building s tudy. Logistic regression models were developed using significant risk factors identified in the univariate analysis. Setting: Four midweste rn hospitals. Patients: Convenience sample of 400 patients who underwe nt abdominal surgical procedures between January 1993 and August 1995. Measurements and results: Multicriteria outcome for postoperative pul monary complication used to collectively assess atelectasis and pneumo nia. Twenty-three risk factors were assessed. Six risk factors were id entified as independent by logistic regression: age greater than or eq ual to 60 years (adjusted odds ratio [Adj OR], 1.89); impaired preoper ative cognitive function (Adj OR, 5.93); smoking history within the pa st 8 weeks (Adj OR, 2.27); body mass index: greater than or equal to 2 7 (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). Conclusions: These results provide a framework for identifying patient s at risk of developing a PPC following abdominal surgery. A reliable and valid risk index could be used clinically to guide preoperative an d postoperative pulmonary care and target limited resources for patien ts at risk.