Risk Score of Foster et al for Pulmonary Complications After Pancreatectomy

Description

Foster et al reported a score for predicting the risk of pulmonary complications after a pancreatectomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from Virginia Commonwealth University and the University of Virginia.

Patient selection: pancreatectomy

Outcome: 30-day risk of unplanned reintubation, postoperative pneumonia, failure to liberate from mechanical ventilation within 48 hours of being intubated

Parameters:

(1) age in years

(2) sex

(3) serum albumin prior to surgery in g/dL

(4) ASA class

(5) surgical acuity

(6) history of severe COPD

(7) smoking status

(8) dyspnea

(9) functional dependency

(10) disseminated cancer

(11) total operation time in minutes

(12) preoperative sepsis

(13) hypertension requiring medication

(14) preoperative serum creatinine in mg/dL

Parameter	Finding	Points
age	< 60 years	0
	60 to 69 years	10
	70 to 79 years	30
	>= 80 years	52
sex	female	0
	male	28
serum albumin	< 3.5 g/dL	40
	>= 3.5 g/dL	0
ASA class	I or II	0
	III, IV or V	44
surgical acuity	emergency	96
	urgent or elective	0
history of severe COPD	no	0
	yes	66
smoking status	current or within past year	35
	stopped > 1 year	0
	never	0
dyspnea	none or mild	0
	moderate or at rest	54
functional dependency	none	0
	partial or total	89
disseminated cancer	no	0
	yes	49
operation time	< 213 minutes	0
	213 to 302 minutes	22
	303 to 402 minutes	42
	>= 403	88
preoperative sepsis	no	0
	yes	84
hypertension requiring medications	no	0
	yes	35
preoperative creatinine	<= 1.2 mg/dL	0
	> 1.2 mg/dL	39

total score =

= SUM(points for all 14 parameters)

Interpretation:

• minimum score: 0

• maximum score: 799

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

Score	Pulmonary Complications
< 97	3%
97 to 158	5.5%
159 to 225	9.7%
> 225	18%

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Risk Score of Foster et al for Pulmonary Complications After Pancreatectomy

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