Foster et al reported a score for predicting the risk of pulmonary complications after a aortoiliac open procedure. This can help to identify a patient who may benefit from more aggressive management. The authors are from Virginia Commonwealth University and the University of Virginia.
Patient selection: aortoiliac open procedure
Outcome: 30-day risk of unplanned reintubation, postoperative pneumonia, failure to liberate from mechanical ventilation within 48 hours of being intubated
Parameters:
(1) age in years
(2) serum albumin prior to surgery in g/dL
(3) ASA class
(4) surgical acuity
(5) history of severe COPD
(6) smoking status
(7) dyspnea
(8) functional dependency
(9) total operation time in minutes
(10) preoperative sepsis
(11) congestive heart failure in the 30 days prior to surgery
Parameter
Finding
Points
age
< 60 years
0
60 to 69 years
13
70 to 79 years
19
>= 80 years
13
serum albumin
< 3.5 g/dL
18
>= 3.5 g/dL
0
ASA class
I or II
0
III, IV or V
38
surgical acuity
emergency
37
urgent or elective
0
history of severe COPD
no
0
yes
20
smoking status
current or within past year
10
stopped > 1 year
0
never
0
dyspnea
none or mild
0
moderate or at rest
13
functional dependency
none
0
partial or total
16
operation time
< 144 minutes
0
144 to 202 minutes
29
203 to 276 minutes
46
>= 277
79
preoperative sepsis
no
0
yes
32
congestive heart failure
no
0
yes
34
total score =
= SUM(points for all 14 parameters)
Interpretation:
• minimum score: 0
• maximum score: 310
• The higher the score the greater the risk of postoperative pulmonary complications.
Score
Pulmonary Complications
< 72
1.4-2.2%
72 to 107
6.4-6.7%
108 to 139
11.9-12.3%
> 139
20.5-23.5%
To read more or access our algorithms and calculators, please log in or register.
