Predictors of postoperative pulmonary complications in critically ill orthopedic patients

Predictors of postoperative pulmonary complications in critically ill orthopedic patientsDear Editor, Postoperative pulmonary complications (PPCs) are a major source of postoperative morbidity and are associated with intensive care use, prolonged hospitalization, and early mortality after noncardiothoracic surgery.1,2 Critically ill orthopedic patients may be particularly vulnerable because advanced age, frailty, cardiopulmonary comorbidity, emergency surgery, prolonged anesthesia, and immobility frequently coexist.Nevertheless, data specific to this high-risk population remain limited.We therefore examined clinical and perioperative factors associated with PPCs in critically ill patients undergoing orthopedic surgery (see Table 1).We retrospectively reviewed critically ill orthopedic patients who underwent orthopedic surgery at our hospital between January 2021 and December 2024.The primary outcome was a composite of postoperative pulmonary complications, including pneumonia, atelectasis, pulmonary edema, pleural effusion, respiratory failure, and unplanned reintubation within 30 days postoperatively.3 Secondary outcomes included intensive care unit (ICU) length of stay, hospital length of stay, and 30-day mortality.Continuous variables were compared using the independentsamples Student's t-test and expressed as mean ± standard deviation, while categorical variables were compared using Pearson's chi-square test and presented as frequencies (percentages).