FREQUENCY OF POST-OPERATIVE PULMONARY COMPLICATIONS AND MORTALITY IN PATIENTS UNDERGOING ABDOMINAL SURGERY

Abstract

Background: Postoperative pulmonary complications (PPCs) are among the most frequent adverse events following abdominal surgery and are associated with increased morbidity, prolonged hospitalization, higher healthcare costs, and mortality. Early identification of high-risk patients is essential for implementing preventive strategies and improving postoperative outcomes. Objective: To determine the frequency of postoperative pulmonary complications and mortality among patients undergoing abdominal surgery and to identify factors associated with the development of PPCs. Place and Duration of study: From March 2026 to July 2026 General Surgery Department, Mohtarma Shaheed Benazir Bhutto General Hospital Quetta. Balochistan. Methodology: This prospective observational study was conducted in the Department of General Surgery of a tertiary care teaching hospital from March to July 2026. A total of 100 adult patients undergoing elective or emergency abdominal surgery under general anesthesia were enrolled using consecutive non-probability sampling. Patients with chronic respiratory failure, active pulmonary tuberculosis, preoperative mechanical ventilation, thoracic surgery, or incomplete clinical records were excluded. Patients were followed until hospital discharge for the development of PPCs and mortality. Data were analyzed using IBM SPSS Statistics version 26.0. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Independent samples t-test, Chi-square test, Fisher's exact test, and multivariable logistic regression were used. A p-value ≤0.05 was considered statistically significant. Results: The mean age of the participants was 51.8 ± 14.2 years, and 62% were male. Postoperative pulmonary complications occurred in 24 (24%) patients, including pneumonia (10%), atelectasis (7%), pleural effusion (4%), and respiratory failure (3%). The overall in-hospital mortality rate was 8%, with significantly higher mortality among patients with PPCs than those without PPCs (20.8% vs. 3.9%; p=0.012). Patients with PPCs had significantly longer hospital stays (11.6 ± 4.3 vs. 6.8 ± 2.7 days; p<0.001). Advanced age, smoking, diabetes mellitus, emergency surgery, and operative duration >3 hours were significantly associated with PPCs. Multivariable logistic regression identified advanced age, emergency surgery, and prolonged operative duration as independent predictors. Conclusion: Postoperative pulmonary complications occurred in nearly one-quarter of patients undergoing abdominal surgery and were significantly associated with prolonged hospitalization and increased in-hospital mortality. Early identification of high-risk patients and implementation of evidence-based perioperative pulmonary care may reduce the incidence of PPCs and improve postoperative outcomes.