Materials and Method: This retrospective study included 239 patients aged ?65 years who underwent elective major abdominal surgery. Clinical and perioperative data were analyzed, and postoperative pulmonary complications?such as bronchospasm, infiltration, infection, atelectasis, pneumothorax, or acute respiratory distress syndrome?were assessed. Logistic regression identified independent predictors.
Results: The incidence of postoperative pulmonary complications was 22.2% (n=53). Patients with complications were older (p < 0.001) and slightly higher intraoperative positive end-expiratory pressure levels (p = 0.007), although other ventilatory parameters were not fully available. Multivariate analysis identified age (OR = 1.097; p = 0.005), positive end-expiratory pressure (OR = 1.452; p = 0.014), ASA ? 3 (OR = 30.532; p < 0.001), and upper abdominal surgery (OR = 2.322; p = 0.022) with the caveat that positive end-expiratory pressure evaluation was limited by the retrospective study design as independent risk factors.
Conclusion: Advanced age, high American Society of Anesthesiologists scores, upper abdominal surgery, and higher intraoperative PEEP were associated with increased postoperative pulmonary complication risk in elderly abdominal surgery patients. Due to limitations in available ventilatory data, the association of PEEP with complications should be interpreted cautiously. Optimizing preoperative status may help reduce complications and improve postoperative outcomes in this population.
Keywords : Postoperative Complications; Pneumonia; Geriatrics; General Surgery