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Risk Index of Canet et al for Predicting Pulmonary Complications Following Surgery

Purpose: To evaluate a surgical patient for the risk of postoperative pulmonary complications using the risk index of Canet et al.

Description

Canet et al developed an index for predicting pulmonary complications following surgery. These can help to identify patients who may benefit from more aggressive pulmonary management. The authors are from multiple hospitals in Spain and the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Group investigators.


Patient selection: age >= 18 years, nonambulatory, non-obstetrical, non organ transplant

 

Postoperative pulmonary complications include:

(1) respiratory infection

(2) respiratory failure

(3) pleural effusion

(4) atelectasis

(5) pneumothorax

(6) bronchospasm

(7) aspiration pneumonitis

 

Parameters:

(1) age in years

(2) preoperative oxygen saturation

(3) history of a respiratory infection in the past month

(4) preoperative anemia

(5) location of the surgical incision

(6) duration of the surgery in hours

(7) emergency surgery

 

Parameter

Finding

Points

age in years

<= 50

0

 

51 to 80

3

 

> 80

16

preoperative oxygen saturation

<= 90%

24

 

91 to 95%

8

 

>= 96%

0

respiratory infection past month

no

0

 

yes

17

preoperative hemoglobin

> 10 g/dL

0

 

<= 10 g/dL

11

location of incision

intrathoracic

24

 

upper abdominal

15

 

other (peripheral)

0

duration of surgery

<= 2 hours

0

 

2.1 to 3 hours

16

 

> 3 hours

23

emergency surgery

no

0

 

yes

8

 

risk index =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 123

• The higher the score the greater the risk of pulmonary complications.

 

Risk Index

Level of Risk

0 to 25

low risk

26 to 44

moderate risk

45 to 123

high risk

 

Performance:

• The cutoff >= 26 showed a sensitivity of 87% and specificity of 79%.

• The cutoff >= 45 showed a sensitivity of 62% and specificity of 97%.


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Specialty

Objective

ICD-10