Siddiqui Khalid M, Farooqui Muhammad H, Yousuf Muhammad S, Ali Muhammad A
Department of Anaesthesiology, Aga Khan University Hospital, Karachi, Pakistan.
Ann Med Surg (Lond). 2024 May 20;86(7):3873-3879. doi: 10.1097/MS9.0000000000002191. eCollection 2024 Jul.
Postoperative pulmonary complications (PPCs) could lead to morbidity, mortality, and prolonged hospital stay. Different risk-scoring systems are used to predict the identification of patients at risk of developing PPCs. The diagnostic accuracies of the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) and Local Assessment of Ventilatory Management During General Anaesthesia for Surgery (LAS VEGAS) risk scores are compared in prediction of PPCs taking pulmonary complication as the gold standard in cardiac surgery.
A prospective cohort study with consecutive sampling technique. A total of 181 patients were included. Quantitative data is presented as simple descriptive statistics giving mean and standard deviation, and qualitative variables are presented as frequency and percentages. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies are also calculated.
Total 181 post-cardiac surgery patients were analyzed. The median [interquartile range] of age, height, weight, and BMI were 60.0 [52.0-67.0] years, 163.0 [156.0-168.0] cm, 71.0 [65.0-80.0] kg and 27.3 [24.2-30.4] kg/m. 127 (70.2%) were male, and 54 (29.8%) were female. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ARISCAT for the prediction of PPCs were (94.9%, 4.65%, 76.1%, 22.9% and 73.4%), whereas LAS VEGAS were (97.1%, 4.65%, 76.5%, 33.3% and 75.1%), respectively.
Both the ARISCAT and LAS VEGAS risk scores are of limited value in cardiac surgery patients for the prediction of postoperative pulmonary complications, based on the predicted scores in this study.
术后肺部并发症(PPCs)可导致发病、死亡及住院时间延长。不同的风险评分系统用于预测哪些患者有发生PPCs的风险。在心脏手术中,以肺部并发症为金标准,比较加泰罗尼亚外科患者呼吸风险评估(ARISCAT)和全麻手术通气管理局部评估(LAS VEGAS)风险评分在预测PPCs方面的诊断准确性。
采用连续抽样技术进行前瞻性队列研究。共纳入181例患者。定量数据以给出均值和标准差的简单描述性统计呈现,定性变量以频率和百分比呈现。还计算了敏感性、特异性、阳性和阴性预测值以及诊断准确性。
共分析了181例心脏手术后患者。年龄、身高、体重和BMI的中位数[四分位间距]分别为60.0[52.0 - 67.0]岁、163.0[156.0 - 168.0]厘米、71.0[65.0 - 80.0]千克和27.3[24.2 - 30.4]千克/平方米。127例(70.2%)为男性,54例(29.8%)为女性。ARISCAT预测PPCs的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为(94.9%、4.65%、76.1%、22.9%和73.4%),而LAS VEGAS分别为(97.1%、4.65%、76.5%、33.3%和75.1%)。
根据本研究中的预测评分,ARISCAT和LAS VEGAS风险评分在心脏手术患者预测术后肺部并发症方面价值有限。