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The LAS VEGAS risk ...
The LAS VEGAS risk score for prediction of postoperative pulmonary complications : An observational study
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Neto, Ary Serpa (author)
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da Costa, Luiz Guilherme V (author)
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Hemmes, Sabrine N T (author)
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Canet, Jaume (author)
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- Hedenstierna, Göran, 1941- (author)
- Uppsala universitet,Klinisk fysiologi,Hedenstiernalaboratoriet
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Jaber, Samir (author)
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Hiesmayr, Michael (author)
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Hollmann, Markus W (author)
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Mills, Gary H (author)
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Vidal Melo, Marcos F (author)
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Pearse, Rupert (author)
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Putensen, Christian (author)
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Schmid, Werner (author)
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Severgnini, Paolo (author)
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Wrigge, Hermann (author)
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Gama de Abreu, Marcelo (author)
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Pelosi, Paolo (author)
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Schultz, Marcus J (author)
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(creator_code:org_t)
- 2018
- 2018
- English.
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In: European Journal of Anaesthesiology. - 0265-0215 .- 1365-2346. ; 35:9, s. 691-701
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs.OBJECTIVE: We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data.DESIGN: This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study.SETTINGS: A total of 146 hospitals across 29 countries.PATIENTS: Adult patients requiring intra-operative ventilation during general anaesthesia for surgery.INTERVENTIONS: The cohort was randomly divided into a development subsample to construct a predictive model, and a subsample for validation.MAIN OUTCOME MEASURES: Prediction performance of developed models for PPCs.RESULTS: Of the 6063 patients analysed, 10.9% developed at least one PPC. Regression modelling identified 13 independent risk factors for PPCs: six patient characteristics [higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO2 and a history of active cancer or obstructive sleep apnoea], two procedure-related features (urgent or emergency surgery and surgery lasting ≥ 1 h), and five intra-operative events [use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH2O and use of vasopressors]. The area under the receiver operating characteristic curve of the LAS VEGAS risk score for prediction of PPCs was 0.78 [95% confidence interval (95% CI), 0.76 to 0.80] for the development subsample and 0.72 (95% CI, 0.69 to 0.76) for the validation subsample.CONCLUSION: The LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for prediction of PPCs. External validation is needed before use in clinical practice.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, number NCT01601223.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Anestesiologi och intensivvård
- Anaesthesiology and Intensive Care
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Neto, Ary Serpa
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da Costa, Luiz G ...
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Hemmes, Sabrine ...
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Canet, Jaume
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Hedenstierna, Gö ...
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Jaber, Samir
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show more...
-
Hiesmayr, Michae ...
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Hollmann, Markus ...
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Mills, Gary H
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Vidal Melo, Marc ...
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Pearse, Rupert
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Putensen, Christ ...
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Schmid, Werner
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Severgnini, Paol ...
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Wrigge, Hermann
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Gama de Abreu, M ...
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Pelosi, Paolo
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Schultz, Marcus ...
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show less...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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European Journal ...
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Uppsala University