Do ARISCAT Scores Help to Predict the Incidence of Postoperative Pulmonary Complications in Elderly Patients After Upper Abdominal Surgery? An Observational Study at a Single University Hospital.

BackgroundThe incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais.MethodsA retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores.ResultsIn all, 1,100 elderly postoperative patients were analyzed. Their mean age was 73.62 years, and 48.5% were male. The incidence of PPCs was 7.72%, with the most common being pleural effusion, atelectasis, and pneumonia. The average hospital and intensive care unit stays of the PPC patients were significantly longer than those without PPC (25.35 versus 7.30 days, with p < 0.0001; and 8.36 versus 2.84 days, with p 0.010, respectively). Almost 90% of the PPC patients had intermediate-to-high ARISCAT scores, with an average of 43.15 ± 13.58.ConclusionsPPCs are common in elderly patients and are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of geriatric Thai patients into PPC risk groups. Its usage might help to raise healthcare awareness and improve the perioperative management of elderly Thai patients. Moreover, the ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.