DOI: http://dx.doi.org/10.18203/2349-2902.isj20194054

Study of risk, incidence and mortality associated with postoperative pulmonary complications using assess respiratory risk in surgical patients in catalonia score

Kedar M. Tilak, Manjusha M. Litake, Krupa V. Shingada

Abstract


Background: Postoperative pulmonary complications (PPCs) are one of the major complications that are seen in patients undergoing surgeries and are also a significant cause of increased duration of hospital stay and mortality. Owing to their high incidence the present study was done to assess the risk and incidence of PPCs using the assess respiratory risk in surgical patients in catalonia (ARISCAT) score and to observe the mortality related to PPCS.

Methods: The study was done at a tertiary care center over a period of three month and 150 patients were involved. The patients were the categorized into three risk groups and were observed for development of any PPCs.

Results: Out of the 150 patients that were studied, 29 developed some form of PPC. 21 out of these 29 (72.41%) patients were from the high-risk category. 11 out of the 29 patients died in a span of 30 days. Pneumonia was seen to be the most common PPC.

Conclusions: ARISCAT score can be useful as a preoperative evaluation tool to classify patients into risk groups and predict the development of PPC in the high-risk groups and to take measures to reduce the risk of PPCs. We conclude from our study that anemia, emergency surgery and surgery with duration of more than 3 hours were significant factors contributing to both the incidence and mortality of PPCs irrespective of the risk group. 


Keywords


ARISCAT, Postoperative pulmonary complications, Risk, Incidence, Mortality

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References


Smetana, GW, Lawrence, VA, Cornell, JE American College of Physicians, Preoperative pulmonary risk stratification for non cardiothoracic surgery: Systematic review for the American College of Physicians. Ann Intern Med. 2006;144:581–95.

Ferraris VA, Ferraris SP, Singh A. Operative outcome and hospital cost. J Thorac Cardiovasc Surg. 1998;115:593–602.

Smetana, GW. Evaluation of Preoperative Pulmonary Risk. Available at: http://www.uptodate. com/contents/evaluation-of-preoperative-pulmonary-risk?source=search_resultandsearch= pulmonary+evaluationand selectedTitle=1%7E150. Accessed on 2 June 2015.

Fujita, T., Sakurai, K. Multivariate analysis of risk factors for postoperative pneumonia. Am J Surg. 1995;169:304–7.

Gupta H, Gupta PK, Schuller D, Fang X, Miller WJ, Modrykamien A. Development and Validation of a Risk Calculator for Predicting Postoperative Pneumonia. Mayo Clin Proc. 2013;88(11):1241-9.

King DS. Postoperative pulmonary complications. Surg Gynecol Obstet. 1933;56:46–50.

Bevacqua BK. Pre-operative pulmonary evaluation in the patient with suspected respiratory disease. Indian J Anaesth. 2015;59:542-9.

Canet J, Gallart L, Gomar C, Paluzie G, Vallès J, Castillo J, et al. ARISCAT Group, Prediction of postoperative pulmonary complications in a population-based surgical cohort.. Anesthesiology. 2010;113:1338–50.

Mazo V, Sabaté S, Canet J, Gallart L, de Abreu MG, Belda J, et al. Prospective External Validation of a Predictive Score for Postoperative Pulmonary Complications. Anesthesiology. 2014;121(2):219-31.

Jammer I, Wickboldt N, Sander M, Smith A, Schultz MJ, Pelosi P, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015;32:88–105.

Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesthesia. 2017;118(3):317–34.

Kupeli E, Er Dedekarginoglu B, Ulubay G, Eyuboglu FO, Haberal M. American Society of Anesthesiologists Classification Versus ARISCAT Risk Index: Predicting Pulmonary Complications Following Renal Transplant. Exp Clin Transplant. 2017;15(Suppl 1):208-13.

Li C, Yang WH, Zhou J, Wu Y, Li YS, Wen SH, et al. Risk factors for predicting postoperative complications after open infrarenal abdominal aortic aneurysm repair: results from a single vascular center in China. J Clin Anesth. 2013;25:371–8.

Robinson TN, Wu DS, Pointer L, Dunn CL, Cleveland JC Jr, Moss M. Simple frailty score predicts postoperative complications across surgical specialties. Am J Surg. 2013;206(4):544-50.

Arozullah AM, Khuri SF, Henderson WG, Daley J. Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Ann Intern Med. 2001;135:847–5.

Brueckmann B, Villa-Uribe JL, Bateman BT, Grosse-Sundrup M, Hess DR, Schlett CL, et al. Development and validation of a score for prediction of postoperative respiratory complications. Anesthesiology 2013;118:1276–85.

Smith PR, Baig MA, Brito V, Bader F, Bergman MI, Alfonso A. Postoperative pulmonary complications after laparotomy. Respiration. 2010;80:269–74.

Johnson RG, Arozullah AM, Neumayer L, Henderson WG, Hosokawa P, Khuri SF. Multivariable predictors of postoperative respiratory failure after general and vascular surgery: results from the patient safety in surgery study. J Am Coll Surg. 2007;204:1188–98.

Ramachandran SK, Nafiu OO, Ghaferi A, Tremper KK, Shanks A, Kheterpal S. Independent predictors and outcomes of unanticipated early postoperative tracheal intubation after nonemergent, noncardiac surgery. Anesthesiology. 2011;115(1):44-53.

Canet J, Sabaté S, Mazo V, Gallart L, de Abreu MG, Belda J, et al. Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort. A prospective, observational study. Eur J Anaesthesiol. 2015;32:458–70.

Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, et al. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - an observational study in 29 countries. Eur J Anaesthesiol. 2017;34(8):492-507.

Scholes RL, Browning L, Sztendur EM, Denehy L. Duration of anaesthesia, type of surgery, respiratory co-morbidity, predicted VO2max and smoking predict postoperative pulmonary complications after upper abdominal surgery: an observational study. Aust J Physiother. 2009;55:191–8.

Arozullah AM, Daley J, Henderson WG, Khuri SF. Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery. Ann Surg. 2000;232:242–53.

Neto AS, da Costa LGV, Hemmes SNT, Canet J, Hedenstierna G, Jaber S, et al. The LAS VEGAS risk score for prediction of postoperative pulmonary complications: An observational study. Eur J Anaesthesiol. 2018;35(9):691-701.

Leem AY, Jung JY, Lee SC, Kim EY. Prediction of Postoperative Pulmonary Complications Using Preoperative Controlling Nutritional Status (CONUT) Score in Patient with Resectable Non-small Cell Lung Cancer. Curr Dev Nutr. 2019;3(Suppl 1):1186.