Gupta et al reported a model for predicting postoperative respiratory failure. This is based on data from the NSQIP. The authors are from the University of Pittsburgh.
Patient selection: surgical patient
Outcome: requiring ventilation > 48 hours after surgery or unplanned intubation within 30 days of surgery
Parameters:
(1) functional status
(2) ASA class
(3) preoperative sepsis status
(4) surgical acuity
(5) type of surgery
|
Parameter |
Finding |
Points |
|
functional status |
independent |
0 |
|
|
partially dependent |
0.7678 |
|
|
totally dependent |
1.4046 |
|
ASA class |
1 |
-3.5265 |
|
|
2 |
-2.0008 |
|
|
3 |
-0.6201 |
|
|
4 |
0.2441 |
|
|
5 |
0 |
|
preoperative sepsis |
absent |
-0.7840 |
|
|
SIRS |
0 |
|
|
sepsis |
0.2752 |
|
|
septic shock |
0.9035 |
|
surgical acuity |
emergency |
0 |
|
|
nonemergency |
-0.5739 |
|
type of surgery |
hernia |
0 |
|
|
anorectal |
-1.3530 |
|
|
aortic |
1.0781 |
|
|
bariatric |
-1.0112 |
|
|
brain |
0.7336 |
|
|
breast |
-2.6462 |
|
|
cardiac |
0.2744 |
|
|
ENT |
0.1060 |
|
|
foregut |
0.9694 |
|
|
pancreatobiliary |
0.9694 |
|
|
gallbladder |
-0.5668 |
|
|
appendix |
-0.5668 |
|
|
adrenal |
-0.5668 |
|
|
spleen |
-0.5668 |
|
|
intestinal |
0.5737 |
|
|
neck |
-0.5271 |
|
|
OB-GYN |
-1.2431 |
|
|
orthopedic |
-0.8577 |
|
|
other abdominal |
0.2416 |
|
|
peripheral vascular |
-0.2389 |
|
|
skin |
-0.3206 |
|
|
spine |
-0.5220 |
|
|
thoracic |
0.6715 |
|
|
vein |
-2.0080 |
|
|
urology |
0.3093 |
value of X =
= SUM(points for all of the parameters) - 1.7397
probability of postoperative respiratory failure =
= 1 / (1 + EXP((-1) * X))
Specialty: Pulmonology
