• J. Am. Coll. Surg. · Oct 2019

    Development and Validation of Procedure-Specific Risk Score for Predicting Postoperative Pulmonary Complication: A NSQIP Analysis.

    • Carrie A Foster, Eric J Charles, Florence E Turrentine, Min-Woong Sohn, Irving L Kron, and R Scott Jones.
    • Virginia Commonwealth University School of Medicine, Richmond, VA.
    • J. Am. Coll. Surg. 2019 Oct 1; 229 (4): 355-365.e3.

    BackgroundPostoperative pulmonary complications (PPCs; unplanned reintubation, postoperative pneumonia, and failure to liberate from mechanical ventilation within 48 hours), contribute significantly to increased rates of morbidity and mortality. Procedure type is an important factor that contributes risk in generalized PPC prediction models. The objective of this study was to develop and validate procedure-specific risk scores for the 6 procedures with the highest rates of PPCs.Study DesignAmerican College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use File data (2005 to 2015) for patients undergoing pancreatectomy, hepatectomy, esophagectomy, abdominal aortic aneurysm repair, open aortoiliac repair, and lung resection were used for analysis. Multivariable logistic regression was used to develop pulmonary complications risk scores (PCRS) for each procedure. Youden indices were used to identify cutoff points within each PCRS and were further validated using a random selection of the original NSQIP dataset collected.ResultsTwenty-one variables were included in the initial analysis, which yielded unique relative risk score models for each procedure. Within all the risk score models, long operative time (within the last quartile) was a strong predictor of PPCs. An increased rate of PPCs was associated with increasing PCRS values in both the training and validation samples for all procedures.ConclusionsImportant variables were identified for 6 common procedures that yield an increased risk of PPCs. These variables differed by procedure type, outlining the importance of procedure-specific risk scores. Each procedure-specific PCRS developed in this study can be used by health care professionals to better predict the risk of PPCs and to optimize patient outcomes.Copyright © 2019 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…