Patient selection: based on the usual clientele for a VA hospital, with 98.5% were men
Parameters associated with complications:
(1) presurgical impaired sensorium
(2) presurgical BUN in mg/dL
(3) neuromuscular degenerative disease
(4) ASA classification
(5) preoperative serum albumin
(6) hypertension requiring medications
(7) history of congestive heart failure
(8) history of stroke with residual neurologic defect
(90) history of COPD
(10) PTT > 25 seconds
Post-operative parameters:
(11) blood transfusion during surgery
(12) ventilator dependence post-operative
(13) open wound (dehiscence)
(14) cardiopulmonary arrest requiring CPR
(15) deep vein thrombosis or thrombophlebitis
(16) coma > 24 hours
(17) acute renal failure
(18) stroke
(19) pulmonary embolism
(20) surgical site infection
Tumor related parameters:
(21) CNS involvement
where:
• A person with impaired sensorium had mental status changes or delirium associated with the current illness. These patients were acutely confused or delirious and responded to verbal or mild tactile stimulus. Patients with more serious changes in sensorium may have been excluded.
Complications associated with > 50% 30-day mortality:
(1) cardiopulmonary arrest requiring CPR
(2) deep vein thrombosis or thrombophlebitis
(3) coma > 24 hours
(4) acute renal failure
(5) stroke
(6) pulmonary embolism
Predictors of pneumonia:
(1) ASA class >= III
(2) hypertension requiring medications
(3) impaired sensorium
Predictors of failure to wean:
(1) ASA class III
(2) history of congestive heart failure
(3) impaired sensorium
(4) history of stroke with residual neurologic deficit
Predictors of requiring more than 4 units of blood transfusion:
(1) presurgical BUN
(2) impaired sensorium
Predictors of sepsis:
(1) presurgical BUN
(2) blood transfusion > 4 units
(3) ventilator dependence
(4) tumor involving the CNS
(5) wound dehiscence
(6) surgical site infection
Predictors of wound dehiscence:
(1) neuromuscular degenerative disease
(2) history of COPD
(3) aPTT > 25 seconds
Predictors of unplanned intubation post-operatively:
(1) history of COPD
(2) impaired sensorium
(3) blood transfusion during surgery
Predictors of surgical site infection (may be incomplete):
(1) neuromuscular degenerative disease (superficial)
(2) presurgical BUN (deep)
Predictors of urinary tract infection (may be incomplete):
(1) neuromuscular degenerative disease
