Zhang et al reported a nomogram for predicting pneumonia following a craniotomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from First Affiliated Hospital of Harbin Medical Center (Heilongjiang), Yale University and Smilow Cancer Hospital (New Haven).
Patient selection: status post craniotomy
Parameters:
(1) ASA class
(2) ventilator dependent
(3) surgical time in minutes
(4) diagnosis
(5) history of COPD
(6) emergency case
(7) anesthesia
(8) sex
(9) functional health status
(10) hypertension
Parameter
Finding
Points
ASA class
I or II
0
III
62.1
IV or V
100
ventilator dependent
no
0
yes
89
surgical time
< 240 minutes
0
240 to 300 minutes
31.6
> 300 minutes
72.8
diagnosis
tumor
0
cerebrovascular disease
61.6
other
25.5
history of COPD
no
0
yes
58.2
emergency case
no
0
yes
56.9
anesthesia
general
44.5
other
0
sex
female
0
male
40.1
functional health status
independent
0
partially dependent
33.1
totally dependent
39.5
hypertension
no
0
yes
27.9
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 588.4
• The higher the score the greater the risk of pneumonia.
value of X =
= (0.01236 * (score)) - 6.094
probability of postoperative pneumonia =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.80.
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