Neto AS, et al. - In this secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study, researchers developed a new prediction score for postoperative pulmonary complications (PPCs) that uses both pre-operative and intra-operative data. Participants were adult patients requiring intra-operative ventilation during general anaesthesia for surgery. This study comprised a development subsample as well as a subsample for validation. The identified 13 independent risk factors for PPCs included higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO₂ and a history of active cancer or obstructive sleep apnoea, urgent or emergency surgery and surgery lasting ≥ 1 h, use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH₂O and use of vasopressors. Overall, a moderate discriminative ability for prediction of PPCs was shown by the LAS VEGAS risk score including 13 peri-operative characteristics. It needs to be externally validated before use in clinical practice.