Perioperative pulmonary risk evaluation and management for non-cardiothoracic surgery

Alvaro Velasquez, Michelle V. Conde, Valerie A. Lawrence

Research output: Chapter in Book/Report/Conference proceedingChapter


Introduction Postoperative pulmonary complications (PPCs) are as common as cardiac complications following non-cardiothoracic surgery and carry significant morbidity and mortality [1]. The incidence of PPCs was higher than cardiac complications (2.7% vs 2.5%) in the cohort of non-cardiac surgical patients used to validate the Revised Cardiac Risk Index [2]. An earlier study of patients undergoing abdominal surgery revealed not only similar results but also longer hospital stays [3]. More recently, Lawrence et al. in a large retrospective cohort study of patients undergoing hip repair showed that serious pulmonary and cardiac complications have similar incidence and significant impact on mortality and length of stay [4]. Postoperative pulmonary complications are a marker of poor prognosis. In patients with or without respiratory failure following vascular and general surgical procedures, mortality at 30 days in the respiratory failure group was 26.5% compared with 1.4% in those without it [5]. Similarly, a prospective study of patients age ≥ 70 years examined predictors of mortality up to 3 years following non-cardiac surgery. Postoperative pulmonary complications were independent predictors of decreased long-term survival [6]. These findings confirm the clinical importance of PPCs.

Original languageEnglish (US)
Title of host publicationMedical Management of the Surgical Patient
Subtitle of host publicationA Textbook of Perioperative Medicine, Fifth Edition
PublisherCambridge University Press
Number of pages14
ISBN (Electronic)9780511920660
ISBN (Print)9781107009165
StatePublished - Jan 1 2010

ASJC Scopus subject areas

  • Medicine(all)


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