Key result
Postoperative pulmonary complications do not differ across abdominal surgical specialties after propensity weighting.
Why the study?
It remained unclear whether variations in postoperative pulmonary complications across abdominal surgical specialties stem from patient-related factors and anaesthesia duration or the surgical specialty itself.
Does the surgical specialty (urological, gastrointestinal, or gynaecological) independently influence the incidence of postoperative pulmonary complications in patients undergoing abdominal surgery after accounting for patient-related factors and anaesthesia duration?
Observational (n=3,306)
Yes
Does the surgical specialty (urological, gastrointestinal, or gynaecological) independently influence the incidence of postoperative pulmonary complications in patients undergoing abdominal surgery after accounting for patient-related factors and anaesthesia duration?
Answers are grounded in this paper and cite their sources.
Differences in the incidence of postoperative pulmonary complications across urological, gastrointestinal, and gynaecological abdominal surgeries are primarily driven by baseline patient-related factors and anaesthesia duration rather than the surgical specialty itself.
BACKGROUND The incidence of postoperative pulmonary complications (PPCs5) following abdominal surgery varies across surgical specialties. It remains unclear to what extent the incidence of PPCs is attributable to known patient-related factors and anaesthesia duration, rather than to differences inherent to the surgical specialty itself. METHODS Post-hoc analysis of an observational study describing postoperative outcomes in patients undergoing urological, gastrointestinal, and gynaecological abdominal surgery. The primary endpoint was a composite measure of PPCs. Secondary endpoints included the individual incidence of each PPC. Propensity score weighting was used to create a cohort with similar patient characteristics and anaesthesia duration. RESULTS The cohort consisted of 3306 patients across 146 centres in 29 countries-367 underwent urological surgery, 2100 underwent gastrointestinal surgery, and 839 underwent gynaecological surgery. Risk scores for PPCs were highest in urological surgical patients, followed by gastrointestinal and gynaecological surgical patients. PPCs also occurred most often after urological surgery (17.7%), followed by gastrointestinal (14.9%) and gynaecological surgery (9.8%) (p < 0.001). After weighting, these differences in incidence disappeared, with comparable rates across the three groups (urological surgery 15.7%, gastrointestinal 14.5%, gynaecological 12.2%; p = 0.340). Apart from unplanned supplementary oxygen, all PPCs were most frequent after gastrointestinal surgery and least common following gynaecological surgery. CONCLUSIONS In this worldwide cohort of patients undergoing abdominal surgery, the incidence of PPCs varied across urological, gastrointestinal, and gynaecological surgery; the differences in incidence may be more strongly influenced by patient-related factors and anaesthesia duration than by the characteristics of the surgical specialty itself. Gastrointestinal surgeries showed the highest rates of severe PPCs.
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Vermeulen et al. (2025) conducted an observational in Postoperative pulmonary complications following abdominal surgery (n=3,306). Urological abdominal surgery vs. Gastrointestinal and gynaecological abdominal surgery was evaluated on Composite measure of postoperative pulmonary complications (PPCs) (p=< 0.001). Urological, gastrointestinal, and gynaecological surgeries had unadjusted PPC rates of 17.7%, 14.9%, and 9.8% (p<0.001), which equalized after propensity weighting (15.7%, 14.5%, 12.2%; p=0.340).
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