Review: surgical site, advanced age, and comorbid conditions increase risk for postoperative pulmonary complications.

M e t h o d s Data sources: MEDLINE (1980 to June 2005) and bibliographies of relevant studies. Study selection and assessment: English-language studies of any design that provided primary data on well-defined PPCs after noncardiothoracic surgery in adults. Excluded were studies with < 25 patients/group; that studied only nonclinical outcomes, identified PPCs by administrative data, or had outcomes unique to certain types of surgery; from developing countries; involving gastric pH manipulation; or involving ambulatory, cardiopulmonary, or organ transplant surgery. Studies that met the selection criteria included 27 studies (26 prospective cohort studies and 1 case–control study) with multivariate analysis (324 648 patients with 10 960 PPCs) and 83 studies of various designs with univariate analysis (173 500 patients with 11 851 PPCs). Quality assessment was done using the U.S. Preventive Services Task Force criteria. Outcomes: PPCs including atelectasis, pneumonia, and respiratory failure.