Postoperative pulmonary complications updating

Abstract

Postoperative pulmonary complications (PPCs) are a major contributor to the overall risk of surgery. PPCs affect the length of hospital stay and are associated with a higher in-hospital mortality. PPCs are even the leading cause of death either in cardiothoracic surgery but also in non-cardiothoracic surgery. Thus, reliable PPCs risk stratification tools are the key issue of clinical decision making in the perioperative period. When the risk is clearly identified related to the patient according the ARISCAT score and/or the type of surgery (mainly thoracic and abdominal), low-cost preemptive interventions improve outcomes and new strategies can be developed to prevent this risk. The EuSOS, PERISCOPE and IMPROVE studies demonstrated this care optimization by risk identification first, then risk stratification and new care (multifaceted) strategies implementation allowing a decrease in PPCs mortality by optimizing the clinical path of the patient and the care resources.

Keywords: Complications pulmonaires postopératoires; Facteurs de risque; Health care resources; Intervention préventive; Mortalité postopératoire; Outcome assessment; Postoperative mortality; Postoperative pulmonary complications; Preemptive intervention; Ressources de soin; Risk factors; Risk stratification; Stratification du risque; Évaluation du devenir.