Key result
The ARISCAT risk score demonstrated 100% sensitivity and 90.5% specificity for predicting postoperative respiratory failure, with good agreement to CPET values (81.45% agreement, kappa 0.54, p<0.001).
Why the study?
Postoperative pulmonary complications are common after surgery, and the study aimed to explore the correlation of the ARISCAT score and CPET values in predicting postoperative pulmonary complications.
Does the ARISCAT risk score correlate with CPET values in predicting postoperative pulmonary complications in cancer patients undergoing major abdominal surgery?
Cross-Sectional
No
Does the ARISCAT risk score correlate with CPET values in predicting postoperative pulmonary complications in cancer patients undergoing major abdominal surgery?
The ARISCAT score shows good agreement with CPET values and high sensitivity and specificity for predicting postoperative pulmonary complications in cancer patients undergoing major abdominal surgery.
ARISCAT-CPET correlation for postoperative respiratory risk remains hypothesis-generating; leaves open prospective validation before any clinical adoption.
Background and Aims Pulmonary complications are common after surgery. They include vascular thrombosis, pneumonia, respiratory failure (RF), and pain‐related atelectasis. There are a number of models to predict the risk of postoperative respiratory events other than thrombosis. The aim of this study was to explore the correlation of assess respiratory risk in surgical patients in Catalonia (ARISCAT) scoring and cardiopulmonary exercise test (CPET) values in prediction of postoperative pulmonary complications (PPCs). Methods Cancer patients referred to a tertiary hospital for elective major abdominal surgeries were studied. Patients were evaluated by ARISCAT score and then CPET was performed to determine the risk of surgery based on maximal oxygen consumption (VO2) value. Patients were followed for RF occurrence up to 72 h after surgery. Finally, the concordance of ARISCAT score and CPET values was evaluated in risk prediction of PPCs. Results The results showed that parameters VO2, ARISCAT score, and anaerobic threshold could predict postoperative RF. Of these parameters, ARISCAT showed the highest sensitivity (100%) and the highest specificity (90.5%) compared with other parameters (Youden's J statistic = 0.905). However, VO2 value showed the highest validity. The percentage of agreement between different subgroups (low, medium, and high) of both criteria (VO2 and ARISCAT) was equal to 81.45% (p < 0.001) and the ϰ coefficient of the given weight was equal to 0.54 (p < 0.001), indicating a good agreement between these two criteria. Conclusion ARISCAT scoring showed high sensitivity and specificity to PPCs in cancer patients and good correlation with CPET value for prediction of PPCs. Therefore, it is a reliable and robust risk prediction tool in major abdominal surgeries on cancer patients.
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Rezaian et al. (2023) conducted a cross-sectional in Cancer patients undergoing elective major abdominal surgeries. ARISCAT risk score vs. Cardiopulmonary exercise test (CPET) values was evaluated on Concordance between ARISCAT score and CPET values in risk prediction of postoperative pulmonary complications (kappa 0.54, p=<0.001). The ARISCAT risk score demonstrated 100% sensitivity and 90.5% specificity for predicting postoperative respiratory failure, with good agreement to CPET values (81.45% agreement, kappa 0.54, p<0.001).
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