Risk Factors for Postoperative Pulmonary Complications in Cardiac Surgery Patients: A Single-Center Retrospective Study

Objective : To determine the incidence and structure of postoperative pulmonary complications (PPCs) and to identify independent risk factors for their development in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Materials and Methods : A retrospective single-center study included 658 patients who underwent cardiac surgery in 2024. Demographic, anamnestic, intra- and postoperative data were analyzed. Univariate and multivariate logistic regression analyses were used to identify risk factors for postoperative complications. Results : PPCs were observed in 71 (10.8%) patients. Atelectasis was the most common complication (7.9%). The incidence of PPCs among smokers was 24.5% (compared to 4.1% among non-smokers), and among obese patients – 21.8% (compared to 6.3% in patients with BMI <30). Multivariate analysis revealed an independent association with the development of PPCs for age >65 years (OR 6.14; 95% CI 3.38–11.16), CPB duration >120 min (OR 5.86; 95% CI 3.57–9.60), smoking history (OR 5.92; 95% CI 2.89– 12.15), obesity (BMI ≥30 kg/m²; OR 5.12; 95% CI 2.70–9.81), and combined surgery (OR 4.69; 95% CI 2.46–8.94). The presence of chronic obstructive pulmonary disease (OR 1.94; 95% CI 1.11–3.39) and pulmonary hypertension (OR 2,14; 95% CI 1.79–5.52) was also associated with an increased risk (all p < 0.001). Conclusions : The identified modifiable risk factors (smoking, obesity) highlight the importance of preoperative optimization. Nonmodifiable factors (age, type of surgery) define a high-risk group requiring increased attention and early prevention of PPC. The findings may contribute to the development of risk stratification algorithms in cardiac surgery practice.