Pedersen et al developed a model for predicting the risk of pulmonary complications after anesthesia and non cardiac surgery. This can help identify patients who may require closer monitoring and more aggressive management in the perioperative period. The authors are from the University of Copenhagen in Denmark.
Pulmonary complications:
(1) respiratory insufficiency
(2) bronchospasm or laryngospasm
(3) hypoxemia
(4) pneumothorax
(5) need for mechanical ventilation for more than 24 hour postoperatively
(6) pneumonia
Pulmonary embolism was considered a cardiovascular complication.
Major surgery included:
(1) open cholecystectomy
(2) perforated peptic ulcer with vagotomy and pyloroplasty
(3) gastrojejunostomy
(4) removal of adhesions in intestinal obstruction
(5) partial or total colectomy
(6) colostomy
(7) explorative laparotomy
(8) caesarean section
(9) thyroidectomy
(10) organ transplantation
(11) renal graftectomy
(12) open reduction and internal fixation of a major fracture
(13) major bone surgery
Parameters affecting risk:
(1) chronic obstructive lung/pulmonary disease (COLD, COPD)
(2) use of muscle relaxants during general anaesthesia
(3) age
(4) major surgery
(5) emergency surgery
|
Parameter |
Finding |
Points |
|
chronic obstructive lung disease |
absent |
0 |
|
|
present |
1.07 |
|
use of muscle relaxants |
no |
0 |
|
|
yes |
1.04 |
|
age of the patient |
< 50 years |
0 |
|
|
50 - 69 years |
1.45 |
|
|
>= 70 years |
1.74 |
|
major surgery |
no |
0 |
|
|
yes |
1.36 |
|
emergency surgery |
no |
0 |
|
|
yes |
0.92 |
X =
= SUM(points for all 6 factors) - 6.18
probability of pulmonary complications =
= EXP(X) / (1 + EXP(X))
Specialty: Pulmonology, Surgery, general
ICD-10: ,
