Although obesity alone is not associated with increased risk of PPCs, assessment of OSA risk and functional status are crucial in these patients [4].

In patients with pulmonary hypertension, having New York Heart Association (NYHA) functional class >2, history of pulmonary embolism, or OSA increases the risk of PPCs [1].

Echocardiography should be considered in patients with suspected heart failure as a cause of dyspnea.

Albumin <3.6 g/dl predicts postoperative pulmonary complications. Surgeons are usually highly attentive to nutritional status for other reasons (overall morbidity, mortality, wound healing, etc.) and may delay surgery for those reasons. It is unclear if correction of hypoalbuminemia changes outcomes; generally, studies of perioperative nutritional supplementation (both enteral and parenteral) have been disappointing [5].

Mild–moderate asthma has not been found to be a risk factor for postoperative pulmonary complications [1].

Diagnostic tests such as a chest X-ray or pulmonary function tests, unless performed for new symptoms or an abnormal exam, often do not change perioperative management and should not be ordered unless there is a clinical indication (see Table 27.2).