Major Postoperative Pulmonary Complications

Unadjusted major pulmonary complication rates were similar in patients with and without preoperative COVID-19. The primary outcome was 30-day major postoperative pulmonary complication. Major postoperative pulmonary complication included pneumonia, acute respiratory distress syndrome or acute respiratory failure, and unexpected postoperative ventilation. The study deliberately restricted the pulmonary outcome to major events rather than broader composites that include minor or transient respiratory events. Poor postoperative pain control is implicated as a contributor to impaired pulmonary recovery after thoracic surgery. MGS-2 criteria include fever above 38°C, elevated white cell count, physician diagnosis of pneumonia, new atelectasis on imaging, purulent sputum, positive sputum culture, room-air saturation below 90%, and unplanned ICU readmission. Postoperative pulmonary complications are assessed using the Melbourne Group Scale 2, with a positive result defined as meeting 4 or more of its criteria.