The ARISCAT score effectively predicts postoperative pneumonia in patients with esophageal squamous cell carcinoma undergoing esophagectomy, aiding risk stratification.

• Pneumonia occurred in 27% of patients (99 of 366).
• Higher ARISCAT scores (59.6 vs. 44.4) correlated with longer tumor lengths (4.5 cm vs. 3.8 cm) and longer hospital stays (17.6 days vs. 13.6 days).

Integrating ARISCAT with inflammatory and nutritional markers improves preoperative assessments, enhancing surgical outcomes.

• Additional predictors include tumor length (adjusted odds ratio 12.44) and length of stay (adjusted odds ratio 2.64).