Development of a Prediction Rule for Estimating Postoperative Pulmonary Complications

作者：Jeong Byeong Ho; Shin Beomsu; Eom Jung Seop; Yoo Hongseok; Song Wonjun; Han Sangbin; Lee Kyung Jong; Jeon Kyeongman; Um Sang Won; Koh Won Jung; Suh Gee Young; Chung Man Pyo; Kim Hojoong; Kwon O Jung; Woo Sookyoung; Park Hye Yun^*

来源：PLos One, 2014, 9(12): e113656.

DOI：10.1371/journal.pone.0113656

Patient-and procedure-related factors associated with postoperative pulmonary complications (PPCs) have changed over the last decade. Therefore, we sought to identify independent risk factors of PPCs and to develop a clinically applicable scoring system. We retrospectively analyzed clinical data from 2,059 patients who received preoperative evaluations from respiratory physicians between June 2011 and October 2012. A new scoring system for estimating PPCs was developed using beta coefficients of the final multiple regression models. Of the 2,059 patients studied, 140 (6.8%) had PPCs. A multiple logistic regression model revealed seven independent risk factors (with scores in parentheses): age %26gt;= 70 years (2 points), current smoker (1 point), the presence of airflow limitation (1 point), American Society of Anesthesiologists class %26gt;= 2 (1 point), serum albumin %26lt;4 g/dL (1 point), emergency surgery (2 points), and non-laparoscopic abdominal/cardiac/aortic aneurysm repair surgery (4 points). The area under the curve was 0.79 (95% CI, 0.75-0.83) with the newly developed model. The new risk stratification including laparoscopic surgery has a good discriminative ability for estimating PPCs in our study cohort. Further research is needed to validate this new prediction rule.

• 出版日期2014-12-1