Smith DK, Freundlich RE, Shinn JR, et al. - Since commonly used predictive models for postoperative pulmonary complications (PPCs) do not perform when applied to head and neck cases, researchers sought to evaluate commonly reported risk factors in a cohort of head and neck patients to assess their ability to predict postoperative pulmonary complications (PPCs). From the electronic medical record, data on 794 free flap head and neck surgery cases at a single center were abstracted. A predictive model was created and was then compared with existing predictive models for PPCs. Age, alcohol consumption, history of congestive heart failure, preoperative packed cell volume, preoperative oxygen saturation, and preoperative metabolic equivalents were reported as predictors of PPCs in the head and neck population using the least absolute shrinkage and selection operator method. The model built in this article for the development of PPCs outperforms existing models.