Incidence and Risk Factors of Postoperative Pulmonary Complications Following General Anesthesia in Adult Patients: A Prospective Observational Study

Postoperative pulmonary complications (PPCs) represent a significant contributor to perioperative morbidity and length of stay in hospital after general anesthesia. They include conditions (atelectasis, pneumonia, hypoxemia and respiratory failure) which have been a major clinical problem even with improved anesthetic and surgical treatment. Aim to establish the prevalence of PPCs and risk factors associated with PPCs in adult surgical patients under general anesthesia. In a prospective observational study, it was carried out at Al-Salam Teaching Hospital during 12 months. It included 150 adult patients (18-70 years old) with an ASA physical status of I-III undergoing elective surgery under general anesthesia. Variables were noted as preoperative, intraoperative and postoperative. PPCs were evaluated 7 days after surgery. The SPSS version 28 was used to analyze the data. Chi-square test and multivariate logistic regression were used to determine associations, and p < 0.05 was considered significant. The overall incidence of PPCs was 30%. The most common complications were hypoxemia (25%) and atelectasis (20%), then pneumonia (10%), and respiratory failure (8%). Patients who developed PPCs were significantly older (58 ± 9 vs. 45 ± 11 years, p < 0.001) and had higher BMI (29.5 ± 4.2 vs. 26.8 ± 3.9 kg/m², p = 0.002), higher rates of smoking (60% vs. 30%, p = 0.001), and COPD (25% vs. 10%, p = 0.01). PPCs were also significantly related to long surgery (>2 hours) and upper abdominal surgeries. The independent predictors identified through multivariate analysis were age >50 years, smoking, COPD and length of the duration of surgery. PPCs occur frequently following general anesthesia and are closely related to both modifiable and non-modifiable risk factors. Risk stratification early and specific preventive measures are vital in enhancing the postoperative outcomes.