Key result
A preoperative risk model incorporating six factors identified patients at risk for postoperative pulmonary complications after CABG surgery with 87% sensitivity and 56% specificity.
Why the study?
Can preoperative risk factors predict postoperative pulmonary complications in adult patients undergoing elective CABG surgery?
Observational (n=117)
No
Can preoperative risk factors predict postoperative pulmonary complications in adult patients undergoing elective CABG surgery?
A simple preoperative risk model using six clinical and pulmonary testing factors can identify patients at high risk for postoperative pulmonary complications after CABG surgery.
Answers are grounded in this paper and cite their sources.
May aid preoperative risk stratification in elective CABG; leaves open prospective validation before clinical adoption.
BACKGROUND AND PURPOSE: Pulmonary complications are among the most frequently reported complications after coronary artery bypass graft (CABG) surgery. However, the risks of postoperative pulmonary complications (PPCs) are not equal for all patients. The aim of this study was to develop a model, based on preoperative factors, for classifying patients with high and low risks for PPCs in order to implement tailored interventions. SUBJECTS AND METHODS: Postoperative pulmonary complications were examined in 117 adult patients who had undergone elective CABG surgery at the University Medical Centre Utrecht, Utrecht, the Netherlands. The presence of preoperative risk factors (N=12) that have been described in the literature was noted for each patient. A risk model was developed by use of logistic regression analysis. RESULTS: Preoperative risk factors for developing PPCs were an age of (>/=70 years, productive cough, diabetes mellitus, and a history of cigarette smoking. Protective factors against the development of PPCs were a predicted inspiratory vital capacity of (>/=75% and a predicted maximal expiratory pressure of (>/=75%. These risk and protective factors were included in the model (sensitivity=87% and specificity=56%), and a sum score for its clinical use was generated. DISCUSSION AND CONCLUSION: Six factors that can be determined easily before surgery, with need for only simple pulmonary testing, can provide a model for identifying patients at risk of developing PPCs after CABG surgery.
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Hulzebos et al. (2003) conducted an observational in Postoperative pulmonary complications after CABG surgery (n=117). Preoperative risk model was evaluated on Postoperative pulmonary complications. A preoperative risk model incorporating six factors identified patients at risk for postoperative pulmonary complications after CABG surgery with 87% sensitivity and 56% specificity.
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