The Role of Pulmonary Function Tests in Preoperative Pulmonary Risk Assessment in Patients with Known and Suspected Pulmonary Disease

Background: This study aims to evaluate the diagnostic accuracy of preoperative oxygen saturation (SpO 2 ) measurements and advanced pulmonary function tests (PFTs) in predicting postoperative pulmonary complications (PPCs) in patients with known or newly diagnosed pulmonary disease who are undergoing elective surgery.The objective is to determine the predictive value of these tests for PPC risk assessment, thereby improving surgical risk stratification and facilitating the development of targeted preventive strategies for high-risk patients. Materials and Methods:This study analyzed data from patients with known pulmonary disease (n = 92) and newly diagnosed pulmonary disease (n = 108) who underwent elective surgery at University of Health Sciences Trkiye, ili Hamidiye Etfal Training and Research Hospital between 2022 and 2023.Patients were assessed preoperatively using the CANET scoring system to evaluate the risk of PPCs.Preoperative SpO 2 and PFT measurements, including Forced Expiratory Volume in One Second (FEV 1 ) and Forced Vital Capacity (FVC), were compared between groups by logistic regression analysis to predict PPCs (p < 0.05).Results: Logistic regression analysis demonstrated that low SpO 2 values (odds ratio [OR] = 0.66, 95% confidence interval [CI] [0.50-0.88],p = 0.004) were significant risk factors for the development of PPCs in Group 1 (known pulmonary disease), while low FEV 1 values (OR = 0.98, 95% CI [0.96-1.00],p = 0.030) were significant risk factors in Group 2 (newly diagnosed pulmonary disease). Conclusion:This study highlights the importance of evaluating preoperative SpO 2 and PFTs jointly in risk assessment using the CANET scoring system, especially in patients with pulmonary disease.Particularly in patients with newly diagnosed pulmonary disease, consideration of PFT results is critical for predicting and preventing PPCs.Integrating PFTs into surgical risk assessment protocols can improve patient outcomes.