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(Chest. 1997;111:564-571.)
© 1997 American College of Chest Physicians

Predictors of Postoperative Pulmonary Complications Following Abdominal Surgery

Jo Ann Brooks-Brunn DNS, RN1

1 From the Department of Pulmonary, Critical Care, and Occupational Medicine, Indiana University School of Medicine, Indianapolis

Study objective: To determine how risk factors could be combined to best predict the development of a postoperative pulmonary complication (PPC) following abdominal surgery.

Design: Prospective model-building study. Logistic regression models were developed using significant risk factors identified in the univariate analysis.

Setting: Four midwestern hospitals.

Patients: Convenience sample of 400 patients who underwent abdominal surgical procedures between January 1993 and August 1995.

Measurements and results: 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 ge60 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 ge27 (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 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.

Key Words: abdominal surgery • postoperative complications • preoperative care • pulmonary complications • risk

Submitted on July 22, 1996
Accepted on September 24, 2007




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