Post-operative pulmonary complications:
(1) pneumonia
(2) respiratory failure
(3) respiratory death
Parameters:
(1) age in years
(2) serum albumin
(3) number of major surgical incisions made
(4) preoperative PaO2 in kPa (on room air)
(5) PEFR as percent of predicted for age and gender (with PEFR measured in liters per minute)
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 67.5
|
0
|
|
|
>= 67.5
|
1
|
|
serum albumin
|
>= 3.9 g/dL
|
0
|
|
|
< 3.9 g/dL
|
1
|
|
number of surgical incisions
|
1
|
0
|
|
|
>= 2
|
1
|
|
preoperative PaO2
|
>= 10 kPa
|
0
|
|
|
< 10 kPa
|
1
|
|
PEFR as percent expected
|
>= 65%
|
0
|
|
|
< 65%
|
1
|
where:
• The combination of thoracotomy and upper abdominal incision have a greater impact on pulmonary function than either alone.
• Conversion from kPa to mm Hg O2 is 7.52; 10 kPa = 75.2 mm Hg.
number of risk factors for post-operative pneumonia =
= (points for PaO2) + (points for albumin) + (points for number of wounds) + (points for PEFR)
number of risk factors for respiratory failure =
= (points for PaO2) + (points for albumin) + (points for PEFR)
number of risk factors for respiratory death =
= (points for PaO2) + (points for albumin) + (points for PEFR)
