• Tom D Vermeulen, Liselotte Hol, Pien Swart, Michael Hiesmayr, Gary H Mills, Christian Putensen, Werner Schmid, Ary Serpa Neto, Paolo Severgnini, Vidal MeloMarcos FMFMassachusetts General Hospital, Department of Anaesthesia, Critical Care and Pain Medicine, 15 Parkman St, MA 02114 Boston, MA, USA; Columbia University, Department of Anesthesiology, 622 W 168th St, NY 10032, New York, USA., Hermann Wrigge, Markus W Hollmann, Gama de AbreuMarceloMUniversity Hospital Carl Gustav Carus, Technical University Dresden, Department of Anaesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, Fetscherstrasse 74, 01307 Dresden, Germany; Cleveland Clinic, Department of I, Marcus J Schultz, Sabrine N Hemmes, David M van Meenen, LAS VEGAS Collaborators group, PROVEnet, and Clinical Trial Network of the European Society of Anaesthesiology.
• Amsterdam University Medical Center, Department of Anaesthesiology, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands. Electronic address: t.d.vermeulen@amsterdamumc.nl.
• J Clin Anesth. 2024 Sep 23; 99: 111565111565.

Study ObjectiveMale sex has inconsistently been associated with the development of postoperative pulmonary complications (PPCs). These studies were different in size, design, population and preoperative risk. We reanalysed the database of 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery study' (LAS VEGAS) to evaluate differences between females and males with respect to PPCs.Design, Setting And PatientsPost hoc unmatched and matched analysis of LAS VEGAS, an international observational study in patients undergoing intraoperative ventilation under general anaesthesia for surgery in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs in the first 5 postoperative days. Individual PPCs, hospital length of stay and mortality were secondary endpoints. Propensity score matching was used to create a similar cohort regarding type of surgery and epidemiological factors with a known association with development of PPCs.Main ResultsThe unmatched cohort consisted of 9697 patients; 5342 (55.1%) females and 4355 (44.9%) males. The matched cohort consisted of 6154 patients; 3077 (50.0%) females and 3077 (50.0%) males. The incidence in PPCs was neither significant between females and males in the unmatched cohort (10.0 vs 10.7%; odds ratio (OR) 0.93 [0.81-1.06]; P = 0.255), nor in the matched cohort (10.5 vs 10.0%; OR 1.05 [0.89-1.25]; P = 0.556). New invasive ventilation occurred less often in females in the unmatched cohort. Hospital length of stay and mortality were similar between females and males in both cohorts.ConclusionsIn this conveniently-sized worldwide cohort of patients receiving intraoperative ventilation under general anaesthesia for surgery, the PPC incidence was not significantly different between sexes.RegistrationLAS VEGAS was registered at clinicaltrial.gov (study identifier NCT01601223).Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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