Postoperative pulmonary complications (PPCs) are the major cause of early mortality in patients who undergo noncardiothoracic surgery. The objective of this study is to evaluate the clinical and radiological PPCs associated with respiratory insufficiency therapies.

This multicenter prospective observational study included a total of 1,202 patients (mean age 62.1 years, 52.9% men) who underwent predominantly abdominal, orthopedic and neurological procedures. The PPCs in the patients were evaluated and associated with early postoperative mortality and hospital stay. The primary outcomes of the study were predefined PPCs within the first 7 days of the surgical procedure.

The findings suggested that at least 1 PPC occurred in 401 patients (33.4%), mainly the requirement for prolonged oxygen therapy by nasal cannula (n=235) and atelectasis (17.1%). Patients with 1 or more PPCs had a higher risk of postoperative mortality, intensive care unit (ICU) admission and hospital/ICU length of stay. The most significant PPC risk factors included nonmodifiable, surgical site, and potentially modifiable.

The research concluded that postoperative pulmonary complications were common in patients undergoing noncardiothoracic surgery, in spite of the use of protective ventilation practices. The findings also suggested that PPCs, even mild, were associated with an increased risk of early postoperative mortality, ICU admission, and hospital/ICU length of stay.