title: Clinical and economic burden of postoperative pulmonary complications: patient safety summit on definition, risk-reducing interventions, and preventive strategies.
abstract: OBJECTIVE
  Postoperative pulmonary complications are a major contributor to the overall risk of surgery. We convened a patient safety summit to discuss ways to enhance physician awareness of postoperative pulmonary complications, advance postoperative pulmonary complications as a substantive public health concern demanding national attention, recommend strategies to reduce the deleterious impact of postoperative pulmonary complications on clinical outcomes and healthcare costs, and establish an algorithm that will help identify patients who are at increased risk for postoperative pulmonary complications.
  
  
  METHODS
  We conducted PubMed searches for relevant literature on postoperative pulmonary complications in addition to using the summit participants' experience in the management of patients with postoperative pulmonary complications.
  
  
  RESULTS
  Postoperative pulmonary complications are common, are associated with increased morbidity and mortality, and adversely affect financial outcomes in health care. A multifaceted approach is necessary to reduce the incidence of postoperative pulmonary complications. Identifying a measurable marker of risk will facilitate the targeted implementation of risk-reduction strategies.
  
  
  CONCLUSIONS
  The most practicable marker that identifies patients at highest risk for postoperative pulmonary complications is the need for postoperative mechanical ventilation of a cumulative duration >48 hrs.
authors.affiliation: Englewood Hospital and Medical Center, Englewood, NJ, USA. aryeh.shander@ehmc.com
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
authors.forename: Lee A
authors.initials: LA
authors.lastname: Fleisher
authors.forename: Philip S
authors.initials: PS
authors.lastname: Barie
authors.forename: Luca M
authors.initials: LM
authors.lastname: Bigatello
authors.forename: Robert N
authors.initials: RN
authors.lastname: Sladen
authors.forename: Charles B
authors.initials: CB
authors.lastname: Watson
mesh_terms: D003428:Cross Infection / Q000191:economics / Q000517:prevention & control; D017048:Health Care Costs; D006801:Humans; D008171:Lung Diseases / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D019990:Perioperative Care; D011183:Postoperative Complications / Q000191:economics / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects; D012307:Risk Factors