Genovese et al developed a predictive score for respiratory adverse events following vascular surgery. The authors are from University of Pittsburgh and University of California Los Angeles.
Patient selection: vascular surgery
Outcome: respiratory adverse events (pneumonia, reintubation after initial intubation)
Parameters:
(1) body mass
(2) age in years
(3) smoking
(4) congestive heart failure (CHF)
(5) chronic obstructive pulmonary disease (COPD)
(6) renal insufficiency
(7) ambulatory status
(8) transfer status
(9) urgency
(10) operative type
|
Parameter |
Finding |
Points |
|
body mass |
underweight |
2 |
|
|
normal, overweight, obese |
0 |
|
|
morbidly obese |
2 |
|
age in years |
< 60 years |
0 |
|
|
60 to 79 years |
2 |
|
|
>= 80 years |
4 |
|
smoking |
never or prior |
0 |
|
|
current |
1 |
|
congestive heart failure |
none |
0 |
|
|
history of |
1 |
|
|
active CHF |
2 |
|
COPD |
none |
0 |
|
|
no treatment or medications only |
3 |
|
|
oxygen dependent |
4 |
|
renal insufficiency |
none or stage 1 |
0 |
|
|
Stage 2 |
1 |
|
|
Stage 3 |
3 |
|
|
Stage 4 |
4 |
|
|
Stage 5 or dialysis |
5 |
|
ambulatory status |
ambulatory |
0 |
|
|
with assistance |
1 |
|
|
non-ambulatory |
3 |
|
transfer status |
from home |
0 |
|
|
from outside facility |
1 |
|
urgency |
elective |
0 |
|
|
urgent |
3 |
|
|
emergent |
9 |
|
operative type |
infrainguinal bypass |
0 |
|
|
EVAR |
1 |
|
|
extra-anatomic bypass |
3 |
|
|
TEVAR (thoracic EVAR) |
6 |
|
|
in situ suprainguinal bypass |
9 |
|
|
open AAA repair |
10 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 41
• The higher the score the greater the risk of a respiratory adverse event.
|
Total Score |
Risk of Respiratory Adverse Events |
|
0 to 11 |
low (< 5%) |
|
12 to 15 |
intermediate (5-10%) |
|
16 to 19 |
intermediate to high (10-20%) |
|
20 to 41 |
high (> 20%) |
Performance:
• The area under the ROC curve is 0.82.
Specialty: Pulmonology, Surgery, general
