Among the following patient-related factors, which is the single strongest predictor of postoperative pulmonary complications according to the American College of Physicians preoperative pulmonary risk assessment?
- A Age above 70 years
- B Serum albumin concentration below 35 g/L ✓
- C Body mass index above 40 kg/m2
- D Well-controlled asthma with normal spirometry
Correct answer: B. Serum albumin concentration below 35 g/L
Explanation
The American College of Physicians systematic review identified low serum albumin, below 35 g/L, as the strongest patient-related predictor of postoperative pulmonary complications, reflecting overall nutritional and physiological reserve. Advanced age and obesity confer modestly increased risk, while well-controlled asthma with normal spirometry carries little additional risk and is not a contraindication to surgery. Procedure-related factors, particularly upper abdominal and thoracic incisions, predict risk even more strongly than any patient factor.
Reference: Miller's Anesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.