Surgery Pulmonary Complications Risk Index - Medical Algorithm

Description

Canet et al developed an index for predicting pulmonary complications following surgery. These can help to identify patients who may benefit from more aggressive pulmonary management. The authors are from multiple hospitals in Spain and the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Group investigators.

Patient selection: age >= 18 years, nonambulatory, non-obstetrical, non organ transplant

Postoperative pulmonary complications include:

(1) respiratory infection

(2) respiratory failure

(3) pleural effusion

(4) atelectasis

(5) pneumothorax

(6) bronchospasm

(7) aspiration pneumonitis

Parameters:

(1) age in years

(2) preoperative oxygen saturation

(3) history of a respiratory infection in the past month

(4) preoperative anemia

(5) location of the surgical incision

(6) duration of the surgery in hours

(7) emergency surgery

Parameter	Finding	Points
age in years	<= 50	0
	51 to 80	3
	> 80	16
preoperative oxygen saturation	<= 90%	24
	91 to 95%	8
	>= 96%	0
respiratory infection past month	no	0
	yes	17
preoperative hemoglobin	> 10 g/dL	0
	<= 10 g/dL	11
location of incision	intrathoracic	24
	upper abdominal	15
	other (peripheral)	0
duration of surgery	<= 2 hours	0
	2.1 to 3 hours	16
	> 3 hours	23
emergency surgery	no	0
	yes	8

risk index =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 123

• The higher the score the greater the risk of pulmonary complications.

Risk Index	Level of Risk
0 to 25	low risk
26 to 44	moderate risk
45 to 123	high risk

Performance:

• The cutoff >= 26 showed a sensitivity of 87% and specificity of 79%.

• The cutoff >= 45 showed a sensitivity of 62% and specificity of 97%.

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Description

Specialty

Objective

ICD-10

Risk Index of Canet et al for Predicting Pulmonary Complications Following Surgery

Purpose: To evaluate a surgical patient for the risk of postoperative pulmonary complications using the risk index of Canet et al.

Description

Specialty

Objective

ICD-10