Risk factors and outcomes of postoperative aspiration pneumo
Postoperative aspiration pneumonia is a feared complication contributing significantly to postoperative morbidity and mortality. Over decades, there has been little progress in reducing the incidence and mortality of postoperative aspiration pneumonia.

Researchers assessed risk factors for postoperative aspiration pneumonia in general and abdominal surgery patients.

Patients undergoing surgery were included in this exact matched and weighted case-control study. Data from a prospectively acquired clinical database were retrospectively analyzed.

Among 23,647 patients undergoing 32,901 operations, 144 cases of postoperative aspiration pneumonia were identified. Ninety-day mortality was 27.8%.

- Major risk factors for postoperative aspiration pneumonia were emergency surgery in patients with prolonged preoperative fasting, older age with increasing risk in octogenarians compared to seniors, American Society of Anesthesiologists scores >II, and body mass index <18 kg/m2.

- Laparoscopies and female sex were associated with a decreased risk for postoperative aspiration pneumonia.

In summary, preventive measures to reduce postoperative aspiration pneumonia should focus on older patients with American Society of Anesthesiologists scores ?III undergoing open surgery. Cachectic patients and patients undergoing emergency surgery with prolonged preoperative fasting require increased attention. Laparoscopy was associated with a lower risk for postoperative aspiration pneumonia and should be preferred whenever appropriate.

Source: https://doi.org/10.1016/j.surg.2021.05.025