Key result
The LAS VEGAS, ARISCAT, and CHI-BPRI risk score scales showed poor predictive accuracy for postoperative pulmonary complications in critically ill patients, with AUCs of 0.625, 0.598, and 0.547, respectively, and no significant differences between them.
Why the study?
ICU patients are at high risk of postoperative pulmonary complications (PPCs), but the comparative predictive value of the LAS VEGAS, ARISCAT, and CHI-BPRI risk assessment tools in critically ill patients was unknown.
Do the LAS VEGAS, ARISCAT, and CHI-BPRI risk score scales accurately predict postoperative pulmonary complications in critically ill patients?
Cohort (n=495)
No
Do the LAS VEGAS, ARISCAT, and CHI-BPRI risk score scales accurately predict postoperative pulmonary complications in critically ill patients?
Effect estimate: AUC difference 0.0269 (95% CI -0.0406 to 0.0944)
Absolute Event Rate: 0.625% vs 0.598%
p-value: p=0.4351
The LAS VEGAS, ARISCAT, and CHI-BPRI scales demonstrated poor predictive accuracy for postoperative pulmonary complications in critically ill Chinese patients, highlighting the need for a tailored risk assessment model.
Suboptimal discrimination by all three scores cautions against sole reliance for PPC risk stratification in ICU; leaves open need for population-specific models.
Background ICU patients are critically ill and complex, with a high risk of PPCs. An effective risk prediction scale can help healthcare professionals quickly identify patients at high risk of PPCs and guide them to take targeted preventive measures as early as possible. Objectives To compare the predictive value of the risk assessment tools LAS VEGAS, Assessment of Respiratory Risk in Catalan Surgical Patients (ARISCAT) and Chinese Brief Predictive Risk Index (CHI-BPRI) of Postoperative Pulmonary Complications (PPCs) regarding the risk of critically ill patients. Methods A retrospective cohort study was conducted with 495 patients transferred to the intensive care unit (ICU) after surgery between January 2020 and December 2020 who were scored using each of the three scales, and the predictive value of the scales was compared by the area under the receiver operating characteristic curve (AUC). Results (1) LAS VEGAS and ARISCAT could be used to predict PPCs; (2) the scores in the group of patients with confirmed PPCs (29 (24,35), 58 (44,72)) were greater than those in the group of patients without PPCs (25.5 (21,30), 52 (38,68)) (P<0.05). (3) In the receiver operating characteristic curve (ROC) analysis, the AUC values were 0.625 (0.567, 0.683) for the LAS VEGAS score, 0.598 (0.537, 0.658) for the ARISCAT score, and 0.547 (0.483, 0.610) for the CHI-BPRI score, with AUC differences of 0.0269, 0.0781, and 0.0513, respectively, which were not statistically significant (P > 0.05). Conclusion The three scales for assessing the occurrence of PPCs in critically ill Chinese patients showed average performance and poor predictive accuracy. In the next study, the characteristics of critically ill Chinese patients can be combined to better explore the development of a predictive model regarding risk factors for PPCs.
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Xu et al. (2023) conducted a cohort in Postoperative pulmonary complications (n=495). LAS VEGAS, ARISCAT, and CHI-BPRI risk score scales vs. Compared to each other was evaluated on Predictive value for postoperative pulmonary complications (Area Under the Curve) (AUC difference 0.0269, 95% CI -0.0406 to 0.0944, p=0.4351). The LAS VEGAS, ARISCAT, and CHI-BPRI risk score scales showed poor predictive accuracy for postoperative pulmonary complications in critically ill patients, with AUCs of 0.625, 0.598, and 0.547, respectively, and no significant differences between them.
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