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The LAS VEGAS risk ...
The LAS VEGAS risk score for prediction of postoperative pulmonary complications : An observational study
- Article/chapterEnglish2018
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LIBRIS-ID:oai:DiVA.org:uu-365778
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-365778URI
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https://doi.org/10.1097/EJA.0000000000000845DOI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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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.
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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-Uppsala universitet,Klinisk fysiologi,Hedenstiernalaboratoriet(Swepub:uu)goranhed
(author)
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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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Uppsala universitetKlinisk fysiologi
(creator_code:org_t)
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In:European Journal of Anaesthesiology35:9, s. 691-7010265-02151365-2346
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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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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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