Pulmonary complications following urological, gastrointestinal and gynaecological abdominal Surgery––A post-hoc analysis of an observational study in 29 countries
Issued Date
2026-01-01
Resource Type
eISSN
23525568
Scopus ID
2-s2.0-105034503782
Pubmed ID
41380776
Journal Title
Anaesthesia Critical Care and Pain Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
Anaesthesia Critical Care and Pain Medicine (2026)
Suggested Citation
Vermeulen T.D., Hemmes S.N.T., Blok S., Schultz M.J., Hiesmayr M., Mills G.H., Putensen C., Schmid W., Serpa Neto A., Severgnini P., Vidal Melo M.F., Wrigge H., Hollmann M.W., Gama de Abreu M., van Meenen D.M.P., Hemmes S.N.T., Neto A.S., Binnekade J.M., Canet J., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M.W., Mills G.H., Vidal Melo M.F., Pearse R., Putensen C., Schmid W., Severgnini P., Wrigge H., de Abreu M.G., Pelosi P., Schultz M.J., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Hiesmayr M., Schmid W., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M.C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Juros-Zovko M., Djonoviċ- Omanoviċ D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Pavicic Saric J., Erceg G., Bogdanovic Dvorscak M., Mazul-Sunko B., Marija Pavicic A., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J. Pulmonary complications following urological, gastrointestinal and gynaecological abdominal Surgery––A post-hoc analysis of an observational study in 29 countries. Anaesthesia Critical Care and Pain Medicine (2026). doi:10.1016/j.accpm.2025.101738 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116108
Title
Pulmonary complications following urological, gastrointestinal and gynaecological abdominal Surgery––A post-hoc analysis of an observational study in 29 countries
Author(s)
Vermeulen T.D.
Hemmes S.N.T.
Blok S.
Schultz M.J.
Hiesmayr M.
Mills G.H.
Putensen C.
Schmid W.
Serpa Neto A.
Severgnini P.
Vidal Melo M.F.
Wrigge H.
Hollmann M.W.
Gama de Abreu M.
van Meenen D.M.P.
Hemmes S.N.T.
Neto A.S.
Binnekade J.M.
Canet J.
Hedenstierna G.
Jaber S.
Hiesmayr M.
Hollmann M.W.
Mills G.H.
Vidal Melo M.F.
Pearse R.
Putensen C.
Schmid W.
Severgnini P.
Wrigge H.
de Abreu M.G.
Pelosi P.
Schultz M.J.
Kroell W.
Metzler H.
Struber G.
Wegscheider T.
Gombotz H.
Hiesmayr M.
Schmid W.
Urbanek B.
Kahn D.
Momeni M.
Pospiech A.
Lois F.
Forget P.
Grosu I.
Poelaert J.
van Mossevelde V.
van Malderen M.C.
Dylst D.
van Melkebeek J.
Beran M.
de Hert S.
De Baerdemaeker L.
Heyse B.
Van Limmen J.
Wyffels P.
Jacobs T.
Roels N.
De Bruyne A.
van de Velde S.
Juros-Zovko M.
Djonoviċ- Omanoviċ D.
Pernar S.
Zunic J.
Miskovic P.
Zilic A.
Kvolik S.
Ivic D.
Azenic-Venzera D.
Skiljic S.
Vinkovic H.
Oputric I.
Juricic K.
Frkovic V.
Kopic J.
Mirkovic I.
Karanovic N.
Carev M.
Dropulic N.
Pavicic Saric J.
Erceg G.
Bogdanovic Dvorscak M.
Mazul-Sunko B.
Marija Pavicic A.
Goranovic T.
Maldini B.
Radocaj T.
Gavranovic Z.
Mladic-Batinica I.
Sehovic M.
Stourac P.
Harazim H.
Smekalova O.
Kosinova M.
Kolacek T.
Hudacek K.
Drab M.
Brujevic J.
Hemmes S.N.T.
Blok S.
Schultz M.J.
Hiesmayr M.
Mills G.H.
Putensen C.
Schmid W.
Serpa Neto A.
Severgnini P.
Vidal Melo M.F.
Wrigge H.
Hollmann M.W.
Gama de Abreu M.
van Meenen D.M.P.
Hemmes S.N.T.
Neto A.S.
Binnekade J.M.
Canet J.
Hedenstierna G.
Jaber S.
Hiesmayr M.
Hollmann M.W.
Mills G.H.
Vidal Melo M.F.
Pearse R.
Putensen C.
Schmid W.
Severgnini P.
Wrigge H.
de Abreu M.G.
Pelosi P.
Schultz M.J.
Kroell W.
Metzler H.
Struber G.
Wegscheider T.
Gombotz H.
Hiesmayr M.
Schmid W.
Urbanek B.
Kahn D.
Momeni M.
Pospiech A.
Lois F.
Forget P.
Grosu I.
Poelaert J.
van Mossevelde V.
van Malderen M.C.
Dylst D.
van Melkebeek J.
Beran M.
de Hert S.
De Baerdemaeker L.
Heyse B.
Van Limmen J.
Wyffels P.
Jacobs T.
Roels N.
De Bruyne A.
van de Velde S.
Juros-Zovko M.
Djonoviċ- Omanoviċ D.
Pernar S.
Zunic J.
Miskovic P.
Zilic A.
Kvolik S.
Ivic D.
Azenic-Venzera D.
Skiljic S.
Vinkovic H.
Oputric I.
Juricic K.
Frkovic V.
Kopic J.
Mirkovic I.
Karanovic N.
Carev M.
Dropulic N.
Pavicic Saric J.
Erceg G.
Bogdanovic Dvorscak M.
Mazul-Sunko B.
Marija Pavicic A.
Goranovic T.
Maldini B.
Radocaj T.
Gavranovic Z.
Mladic-Batinica I.
Sehovic M.
Stourac P.
Harazim H.
Smekalova O.
Kosinova M.
Kolacek T.
Hudacek K.
Drab M.
Brujevic J.
Author's Affiliation
Columbia University
Massachusetts General Hospital
Monash University
Cleveland Clinic Foundation
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
Universitätsklinikum Bonn
Università degli Studi dell'Insubria
Nuffield Department of Medicine
Universitätsklinikum Carl Gustav Carus Dresden
Royal Hallamshire Hospital
Hospital Israelita Albert Einstein
Austin Hospital
Antoni van Leeuwenhoek Ziekenhuis
Mahidol Oxford Tropical Medicine Research Unit
BG-Kliniken Bergmannstrost Halle
Martin−Luther−University of Halle−Wittenberg
Massachusetts General Hospital
Monash University
Cleveland Clinic Foundation
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
Universitätsklinikum Bonn
Università degli Studi dell'Insubria
Nuffield Department of Medicine
Universitätsklinikum Carl Gustav Carus Dresden
Royal Hallamshire Hospital
Hospital Israelita Albert Einstein
Austin Hospital
Antoni van Leeuwenhoek Ziekenhuis
Mahidol Oxford Tropical Medicine Research Unit
BG-Kliniken Bergmannstrost Halle
Martin−Luther−University of Halle−Wittenberg
Corresponding Author(s)
Other Contributor(s)
Abstract
BackgroundThe incidence of postoperative pulmonary complications (PPCs33Postoperative Pulmonary Complications.) 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.MethodsPost-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.ResultsThe 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.ConclusionsIn 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.