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Preoperative prediction of postoperative pulmonary complications is important to know who is at higher risk for perioperative morbidity. A summary of the results from a systematic review of the literature on preoperative risk stratification for postoperative pulmonary complications after noncardiothoracic surgery is shown (American College of Physicians, Ann Intern Med. 2006;144:581-595).
Potential patient-related risk factor 1. Good evidence to support the particular risk factor: Advanced age, ASA class II, CHF, functionally dependent, COPD 2. At least fair evidence to support the particular risk factor: Weight loss, impaired sensorium, cigarette use, alcohol use, abnormal findings on chest examination 3. At least fair evidence to suggest that the particular factor is not a risk factor: Diabetes 4. Not a risk factor: obesity, asthma 5. Insufficient evidence: obstructive sleep apnea, corticosteroid use, HIV infection, arrhythmia, poor exercise capacity Potential procedure-related risk factor 1. Good evidence to support the particular risk factor: aortic aneurysm repair, thoracic surgery, abdominal surgery, upper abdominal surgery, neurosurgery, prolonged surgery, head and neck surgery, emergency surgery, vascular surgery, general anesthesia 2. At least fair evidence to support risk: Perioperative transfusion 4. Not a risk factor: hip surgery, gynecologic or urologic surgery 5. Insufficient evidence: esophageal surgery Laboratory tests 1. Good evidence to support risk: Albumin level < 35g/l 2. At least fair evidence to suppot risk: Chest radiography, BUN level >7.5 mmol (>21mg/dL)
5. Insufficent evidence: Spirometry
References: Preoperative Pulmonary Risk Stratification for Noncardiothoracic Surgery: Systematic Review for the American College of Physicians Gerald W. Smetana, MD; Valerie A. Lawrence, MD; and John E. Cornell, PhD. Ann Intern Med. 2006;144:581-595.
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Risk stratification 
