Development of a predictive model for estimation of postoperative risk following brachycephalic obstructive airway syndrome surgery.

Emergent presentation and high-grade laryngeal collapse are the strongest predictors of major postoperative complications in BOAS surgery.

This retrospective cohort study developed a predictive model for postoperative mortality and complications in dogs undergoing brachycephalic obstructive airway syndrome (BOAS) surgery at a veterinary teaching hospital over an 11-year period (2012–2023). A total of 297 cases were included, with outcomes categorized as death, major complications (airway interventions, pneumonia), or minor complications. Overall mortality prior to discharge was 4% (12 dogs), and major complications occurred in 10% of cases (29 dogs). Multivariable logistic regression identified emergent presentation (OR 7.45), high-grade laryngeal collapse (OR 4.28), female sex (OR 2.78), and history of regurgitation/vomiting (OR 2.16) as significant risk factors for major complications. Predictor variables were organized across domains including signalment, history, clinical signs, underlying pathology, acuity status, and surgical procedures performed. The resulting predictive model allows clinicians to generate individualized postoperative risk estimates based on patient-specific factors, potentially supporting prognostication, triage decisions, and client communication. The authors appropriately caution that the model has not undergone external validation, and calculated risk estimates should be interpreted alongside the full clinical picture. This study addresses a meaningful gap in the BOAS literature by providing a structured, quantitative tool for perioperative risk stratification. Future prospective multicenter studies with external validation cohorts will be important to confirm the model's generalizability and clinical utility across different practice settings.

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