title: Incidence and risk factors of postoperative pulmonary complications in noncardiac Chinese patients: a multicenter observational study in university hospitals.
abstract: 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.
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Guohao
authors.initials: G
authors.lastname: Xie
authors.affiliation: Intensive Care Unit, The Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
authors.forename: Haihong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, China.
authors.forename: Lielie
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Anesthesiology, The Second Affiliated Hospital, Wenzhou Medical College, Wenzhou 325027, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Baoli
authors.initials: B
authors.lastname: Cheng
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, 53127 Bonn, Germany.
authors.forename: Andreas
authors.identifier: 0000-0001-5568-4604
authors.initials: A
authors.lastname: Hoeft
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000401:mortality / Q000601:surgery; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012120:Respiration Disorders / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
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