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  • Ferrando, CarlosInst Invest August Pi & Sunyer, Hosp Clin, Dept Anesthesiol & Crit Care, Barcelona, Spain.;Carlos Iii Hlth Inst, CIBER Resp Dis, Madrid, Spain. (författare)

A noninvasive postoperative clinical score to identify patients at risk for postoperative pulmonary complications : the Air-Test Score

  • Artikel/kapitelEngelska2020

Förlag, utgivningsår, omfång ...

  • EDIZIONI MINERVA MEDICA,2020
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-414955
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-414955URI
  • https://doi.org/10.23736/S0375-9393.19.13932-6DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Postoperative pulmonary complications (PPCs) negatively affect morbidity, healthcare costs and postsurgical survival. Preoperative and intraoperative peripheral oxyhemoglobin saturation (SpO(2)) levels are independent risk factors for postoperative pulmonary complications (PPCs). The air-test assesses the value of SpO(2) while breathing room-air. We aimed at building a clinical score that includes the air-test for predicting the risk for PPCs. METHODS: This is a development and validation study in patients -randomly divided into two cohorts- from a large randomized clinical trial (iPROVE) that enrolled 964 intermediate-to-high risk patients scheduled for abdominal surgery. Arterial oxygenation was assessed on room-air in the preoperative period (preoperative air-test) and 3h after admission to the postoperative care unit (postoperative air-test). The air-test was defined as positive or negative if SpO(2) was <= 96% or >96%, respectively. Positive air-tests were stratified into weak (93-96%) or strong (<93%). The primary outcome was a composite of moderate-to-severe PPCs during the first seven postoperative days. RESULTS: A total of 902 patients were included in the final analysis (542 in the development cohort and 360 in the validation cohort). Regression analysis identified five independent risk factors for PPC: age. type of surgery, pre- and postoperative air-test, and atelectasis. The area under the receiver operating characteristic curve (AUC) was 0.79 (95% CI: 0.75-0.82) when including these five independent predictors. We built a simplified score termed "air-test score" by using only the pre- and postoperative SpO(2) , resulting in an AUC of 0.72 (95% CI: 0.67-0.76) for the derivation and 0.72 (95% CI: 0.66-0.78) for the validation cohort, respectively. The air-test score stratified patients into four levels of risk, with PPCs ranging from <15% to >75%. CONCLUSIONS: The simple, non-invasive and inexpensive bedside air-test score, evaluating pre- and postoperatively SpO(2) measured on room-air, helps to predict the risk for PPCs.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Suarez-Sipmann, FernandoUppsala universitet,Hedenstiernalaboratoriet,Carlos Iii Hlth Inst, CIBER Resp Dis, Madrid, Spain.;La Princesa Hosp, Dept Intens Care Med, Madrid, Spain.(Swepub:uu)fersi946 (författare)
  • Librero, JulianRed Fdn Miguel Servet, Red Invest Serv Salud Enfermedades Cron REDISSEC, Pamplona, Spain. (författare)
  • Pozo, NatividadUniv Clin Hosp Valencia, INCLIVA Clin Res Inst, Valencia, Spain. (författare)
  • Soro, MarinaClin Hosp Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain. (författare)
  • Unzueta, CarmenSt Pau Univ Hosp, Dept Anesthesiol & Crit Care, Mas Barcelona, Spain. (författare)
  • Brunelli, AndreaGermans Tries & Pujol Univ Hosp, Dept Anesthesiol & Crit Care, Badalona, Spain. (författare)
  • Peiro, SalvadorCtr Super Invest Salud Publ CSISP FISABIO, Red Invest Serv Salud Enfermedades Cron REDISSEC, Valencia, Spain. (författare)
  • Llombart, AliciaCorachan Clin, Dept Pharmacol, Barcelona, Spain. (författare)
  • Balust, JaumeInst Invest August Pi & Sunyer, Hosp Clin, Dept Anesthesiol & Crit Care, Barcelona, Spain. (författare)
  • Aldecoa, CesarRio Hortega Univ Hosp, Dept Anesthesiol & Crit Care, Valladolid, Spain. (författare)
  • Diaz-Cambronero, OscarLa Fe Univ Hosp, Dept Anesthesiol & Crit Care, Valencia, Spain. (författare)
  • Franco, TaniaRamon & Cajal Univ Hosp, Dept Anesthesiol & Crit Care, Madrid, Spain. (författare)
  • Redondo, Francisco J.Univ Hosp Ciudad Real, Dept Anesthesiol & Crit Care, Ciudad Real, Spain. (författare)
  • Garutti, IgnacioGregorio Maranon Univ Hosp, Dept Anesthesiol & Crit Care, Madrid, Spain. (författare)
  • Garcia, Jose, IFdn Hosp Alcorcon, Dept Anesthesiol & Crit Care, Alcorcon, Spain. (författare)
  • Ibanez, MaiteMarina Baixa Vila Joiosa Hosp, Dept Anesthesiol, Alicante, Spain. (författare)
  • Granell, ManuelUniv Hosp Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain. (författare)
  • Rodriguez, AurelioDr Negrin Univ Hosp, Dept Anesthesiol, Las Palmas Gran Canaria, Spain. (författare)
  • Gallego, LuciaMiguel Servet Univ Hosp, Dept Anesthesiol & Crit Care, Zaragoza, Spain. (författare)
  • de la Matta, ManuelVirgen Rocio Univ Hosp, Dept Anesthesiol & Crit Care, Seville, Spain. (författare)
  • Marcos, Jose M.Univ Hosp Leon, Dept Anesthesiol, Leon, Spain. (författare)
  • Garcia, JavierPuerta Hierro Univ Hosp, Dept Anesthesiol & Crit Care, Madrid, Spain. (författare)
  • Mazzinari, GuidoManises Hosp, Dept Anesthesiol, Valencia, Spain. (författare)
  • Tusman, GerardoCommunity Private Hosp Mar de Plata, Dept Anesthesiol, Mar De Plata, Argentina. (författare)
  • Villar, JesusCarlos Iii Hlth Inst, CIBER Resp Dis, Madrid, Spain.;Dr Negrin Univ Hosp, Multidisciplinary Organ Dysfunct Evaluat Res Netw, Res Unit, Las Palmas Gran Canaria, Spain. (författare)
  • Belda, JavierClin Hosp Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain.;Univ Valencia, Dept Surg, Valencia, Spain. (författare)
  • Inst Invest August Pi & Sunyer, Hosp Clin, Dept Anesthesiol & Crit Care, Barcelona, Spain.;Carlos Iii Hlth Inst, CIBER Resp Dis, Madrid, Spain.Hedenstiernalaboratoriet (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Minerva Anestesiologica: EDIZIONI MINERVA MEDICA86:4, s. 404-4150375-93931827-1596

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