Incidence and Risk Factors of Postoperative Pneumonia Among Surgical Patients at University of Calabar Teaching Hospital

Postoperative pneumonia is a leading cause of prolonged hospital stay, increased healthcare costs, and mortality following major surgical procedures. This study investigates the incidence and predisposing risk factors of postoperative pneumonia among patients admitted to the surgical wards of University of Calabar Teaching Hospital (UCTH), Cross River State, South South Nigeria, from 2021 to 2023. A prospective cohort design was employed, enrolling 230 patients undergoing elective or emergency abdominal and thoracic surgeries. Patients were monitored for respiratory complications daily for 14 days postoperatively. Pneumonia diagnosis was based on clinical, radiological, and microbiological criteria. Logistic regression was applied to identify independent risk factors. Postoperative pneumonia occurred in 13.5% of patients. Significant risk factors included age over 60 years, emergency surgery, prolonged intubation, and lack of incentive spirometry use. Smoking history and preexisting chronic obstructive pulmonary disease were also significant. The study recommends routine preoperative respiratory physiotherapy, aggressive incentive spirometry protocols, and early mobilization as preventive measures. Antibiotic stewardship and judicious use of mechanical ventilation should also be enforced to reduce hospital-acquired pneumonia in surgical units across South South Nigeria. Keywords: postoperative pneumonia, surgical patients, respiratory complication, Calabar, risk factors