Nafiu OO, Mpody C, Jatana KR, et al. - Given the possible correlation of postoperative pneumonia with morbidity, mortality and substantially increased cost of surgical care, researchers sought to determine factors linked with postoperative pneumonia and ascertain if a subset of children with a disproportionate risk of pneumonia can be identified. Using the National Surgical Quality Improvement- Pediatric (NSQIP-P) database, they selected 17,776 children (age under 18 years) who underwent inpatient pediatric otolaryngology procedures; of these children, 12,443 children formed the derivation cohort. postoperative pneumonia developed in 177 (1.4%) children in the derivation cohort. In these children, key preoperative risk factors for postoperative pneumonia were identified. A large proportion (71%) of postoperative pneumonia occurred in a small proportion (20%) of high-risk patients indicating an underlying Pareto distribution and highlighting the necessity for targeted interventions for this “vital few”. They observed longer hospital stay and a higher risk of mortality in pediatric otolaryngology surgical inpatients in correlation with occurrence of postoperative pneumonia.