INS and chronic obstructive pulmonary disease: Postoperative complications were strongly associated with history of severe chronic obstructive pulmonary disease (COPD) (P = 0.031), dyspnea with minimal exertion (P = 0.041), being at least partially dependent (P = 0.041), smoking within the past year (P = 0.044), American Society of Anesthesiologists (ASA) class of more than 2 (P = 0.000), diabetes treated with insulin (P = 0.003), and steroid use for chronic condition (P = 0.003).