British journal of anaesthesia
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The score for prediction of postoperative respiratory complications in infants and children (SPORC-C) was recently reported. The score was developed using a large cohort of patients by applying a multivariate model, then internally and externally validated on a different cohort of patients. In order to encourage use of this score, an online calculator (https://sites.google.com/view/sporc-for-children/home) was also developed, allowing identification of patients at low and high risk for postoperative respiratory complications. We review current evidence on algorithms developed to predict postoperative respiratory complications, including how and when such scoring systems should be used in daily practice to improve the overall safety of paediatric patients.
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Methoxyethyl etomidate hydrochloride (ET-26) is a novel etomidate analogue. This is the first-in-human study of a bolus i.v. formulation of ET-26 to assess its safety, tolerability, hypnotic effects, and pharmacokinetics. ⋯ ChiCTR2100047525 (https://www.chictr.org.cn/index.aspx, ChiCTR2100047525).
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Risk prediction scores are used to guide clinical decision-making. Our primary objective was to externally validate two patient-specific risk scores for 30-day in-hospital mortality using the Multicenter Perioperative Outcomes Group (MPOG) registry: the Pediatric Risk Assessment (PRAm) score and the intrinsic surgical risk score. The secondary objective was to recalibrate these scores. ⋯ The intrinsic surgical risk score performed better than the PRAm, but both resulted in large numbers of false positives. Both scores exhibited decreased performance compared with the original studies. ASA physical status scores in sicker patients drove the superior performance of the intrinsic surgical risk score, suggesting the use of a risk score does not improve prediction.