Pipanmekaporn et al reported a risk score for predicting respiratory complications after thoracic surgery. The authors are from Chiang Mai University, University of Phayao, Naresuan University and Monash University Malaysia.
Patient selection: adult >= 18 years undergoing noncardiac thoracic surgery
Outcome: respiratory complications (bronchospasm, atelectasis, pneumonia, respiratory failure, ARDS) within 30 days of surgery
Parameters:
(1) COPD
(2) ASA performance status
(3) side of the operation
(4) duration of surgery in minutes
(5) preoperative arterial oxygen saturation SpO2 in percent
(6) operative approach
Parameter
Finding
Points
COPD
absent
0
present
2
ASA performance status
1 or 2
0
>= 3
3.5
side of operation
left
0
right
1.5
duration of surgery
<= 180 minutes
0
> 180 minutes
2.0
preoperative SpO2
>= 96%
0
91 to 95%
1.0
<= 90%
2.5
operative approach
VATS (video assisted thoracoscopy)
0
thoracotomy
1.5
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 13
• The higher the score the greater the risk of respiratory complications.
Total Score
Risk Group
Respiratory Complications
0 to 5.5
low
9%
6.0 to 7.5
moderate
24%
8.0 to 13
high
60%
Performance:
• The area under the ROC curve ranged from 0.76 (derivation cohort) to 0.78 (validation cohort).
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