Incidence And Risk Factors Of Postoperative Pulmonary Complications In Noncardiac Chinese Patients:A Multicenter Observation Study In University Hospitals

Objective:To assess the incidence of postoperative pulmonary complications(PPCs)in Chinese inpatients,and to develop a brief predictive risk index.Methods:Between August 6,2012,and August 12,2012,patients undergoing noncardiac operations in four university hospitals were enrolled.The cohort was divided into two subsamples,cohort 1 to develop a predictive risk index of PPCs and cohort 2 to validate it.Results:1673 patients were enrolled.PPCs were recorded for 163 patients(9.7%),of whom the hospital length of stay(LOS)was longer(P<0.001).The mortality was 1.84%in patients with PPCs and 0.07%in those without.Logistic Regression modeling in cohort 1 identified nine independent risk factors,including smoking,respiratory infection in the last month,preoperative antibiotic use.preoperative saturation of peripheral oxygen,surgery site,blood lost,postoperative blood glucose,albumin,and ventilation.The model was validated within cohort 2 with an area under the receiver operating characteristic curve of 0.90(95%CI 0.86 to 0.94).Conclusions:PPCs are common in noncardiac surgical patients and are associated with prolonged LOS in China.The current study developed a risk index,which can be used to assess individual risk of PPCs and guide individualized perioperative respiratory care.