{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:16:50Z","timestamp":1774876610887,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The aim of this study was to assess whether preoperative pulmonary function testing (PFT) is related to postoperative complications after open thoracoabdominal aortic aneurysm (TAAA) repair. Methods: This study was conducted as a retrospective cohort analysis of 205 patients undergoing open TAAA repair (2006\u20132024) with preoperative spirometry and body plethysmography with at least one value available. Patients were classified by ventilation patterns: obstructive (n = 85, 45.2%), restrictive (n = 26, 14.1%), and hyperinflation (n = 56, 30.3%). Primary endpoints included in-hospital mortality, pulmonary complications (pneumonia, ARDS), and multi-organ outcomes. Associations were analyzed using chi-square and Spearman correlation tests and multivariable linear regression adjusted for age, smoking status, COPD, emergency operation, and time period. Results: Postoperative pulmonary complications occurred in 126 patients (61.5%), including pneumonia (46.8%) and ARDS (15.1%). Reduced vital capacity and FEV1 expressed as a percentage of the lower limit of normal (%LLN) were related to postoperative pneumonia (p = 0.031 and p = 0.003) and ARDS (p = 0.038). Both obstructive and restrictive ventilation patterns were related to acute kidney injury after surgery (all KDIGO stage) (p = 0.044 and p = 0.043, respectively). Hyperinflation was related to atrial fibrillation (p = 0.039) and stroke (p = 0.034). FEV1 &lt; 2.0 L was related to increased mortality risk (p = 0.037), and FEV1 &lt; 1.5 L predicted acute kidney injury (p = 0.017), spinal cord ischemia (p = 0.035), and mortality (p = 0.023). Prolonged mechanical ventilation correlated with reduced preoperative lung function (VC %LLN \u03c1 = \u22120.288, p = 0.002; FEV1 %LLN \u03c1 = \u22120.286, p = 0.001). During median follow-up of 6.35 years, patients in the highest FEV1 quartile demonstrated substantially reduced long-term mortality (HR 0.27, 95% CI 0.10\u20130.73, p = 0.01). These associations between lower FEV1 and VC (expressed as %LLN) with pneumonia, ARDS, in-hospital mortality, and prolonged ventilation remained significant after multivariable analysis. Conclusions: Preoperative pulmonary function assessment may help identify TAAA patients at increased risk of postoperative complications and mortality. Combining percentage-predicted spirometry, ventilation patterns, and hyperinflation markers may support individualized treatment selection, prehabilitation, and perioperative monitoring based on each patient\u2019s specific risk profile.<\/jats:p>","DOI":"10.3390\/jcm15072623","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T12:11:44Z","timestamp":1774872704000},"page":"2623","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Risk Stratification in Open Thoracoabdominal Aortic Aneurysm Repair"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8416-4624","authenticated-orcid":false,"given":"Jelle","family":"Frankort","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"},{"name":"Department of Vascular Surgery, MUMC+, 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Al-Falahi","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andras","family":"Keszei","sequence":"additional","affiliation":[{"name":"Centre for Translational & Clinical Research Aachen (CTC-A), University Hospital RWTH, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7497-1858","authenticated-orcid":false,"given":"Bernhard","family":"Hruschka","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quentin","family":"Cappel","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8451-2913","authenticated-orcid":false,"given":"Alexander","family":"Gombert","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.ejvs.2022.02.003","article-title":"Outcome of Elective and Emergency Open Thoraco-Abdominal Aortic Aneurysm Repair in 255 Cases: A Retrospective Single Centre Study","volume":"63","author":"Gombert","year":"2022","journal-title":"Eur. 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