The magnitude of postoperative pulmonary complications and associated factors after abdominal surgery: retrospective cross-sectional study at MCM Comprehensive Specialized Hospital

Background Postoperative pulmonary complications (PPCs) are major concerns after abdominal surgery, increasing morbidity, mortality, and healthcare costs. Common complications include pneumonia, atelectasis, pleural effusion, ARDS, and pulmonary thromboembolism. Identifying their prevalence and risk factors is vital for prevention and better surgical outcomes. However, limited data exist in our setting. This study assesses the prevalence and associated risk factors of PPCs in adults undergoing abdominal surgery under general anesthesia. Method A single-center cross-sectional study was conducted at MCM Comprehensive Specialized Hospital using records of patients who underwent abdominal surgery from January to December 2024. A total of 248 participants were selected by simple random sampling. Data were analyzed with SPSS v26 using bivariate and multivariate logistic regression. Variables with p < 0.2 entered multivariate analysis, and p < 0.05 was considered statistically significant. Result The mean age of participants was 47.27 ± 18.1 years; 62.9% (156) were male and 37.1% (92) female. Among abdominal surgery patients, 30.2% (75) developed postoperative pulmonary complications (PPCs). The most common PPCs were atelectasis (34.2%), pneumonia (30.5%), and pleural effusion (26.8%), while pulmonary thromboembolism (6.5%) and ARDS (2%) were the least frequent. Significant factors included preoperative anemia (AOR = 6.955, 95% CI = 2.705–17.883, p < 0.001), recent respiratory infection (AOR = 20.365, 95% CI = 2.315–179.185, p = 0.007), surgery > 3 hrs, (AOR = 19.017, 95% CI = 5.807–62.276, p < 0.001), and blood loss > 300 ml (AOR = 7.670, 95% CI = 2.367–24.852, p = 0.001). Postoperative chest physiotherapy (AOR = 0.179, 95% CI = 0.062–0.523, p = 0.002) and early ambulation (AOR = 0.115, 95% CI = 0.045–0.294, p < 0.001) were protective. Conclusion The prevalence of postoperative pulmonary complications after abdominal surgery was high. Factors strongly associated with postoperative pulmonary complications are Preoperative anemia, Recent preoperative respiratory infections, Duration of surgical procedures greater than 3 hours, intra-operative blood loss greater than 300ml, Postoperative chest physiotherapy and early ambulation