Risk score for postoperative complications in thoracic surgery.
10.4097/kjae.2012.63.6.527
- Author:
Mikyung YANG
1
;
Hyun Joo AHN
;
Jie Ae KIM
;
Jae Myung YU
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hyunjooahn@skku.edu
- Publication Type:Original Article
- Keywords:
Postoperative complications;
Risk scores;
Thoracic surgery
- MeSH:
Analgesia, Epidural;
Esophageal Neoplasms;
Forced Expiratory Volume;
Humans;
Logistic Models;
Lung;
Lung Injury;
Pneumonectomy;
Postoperative Complications;
Retrospective Studies;
Risk Factors;
Thoracic Surgery
- From:Korean Journal of Anesthesiology
2012;63(6):527-532
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Risk scoring system for thoracic surgery patients have not been widely used, as of recently. We tried to forge a risk scoring system that predicts the risk of postoperative complications in patients undergoing major thoracic surgery. We used a prolonged ICU stay as a representative of postoperative complications and tested various possible risk factors for its relation. METHODS: Data from all patients who underwent major lung and esophageal cancer surgeries, between 2005 and 2007 in our hospital, were collected retrospectively (n = 858). Multiple logistic regression analysis was performed with various possible risk factors to build the risk scoring system for prolonged ICU stay (> 3 days). RESULTS: A total of 9% of patients exhibited more than 3 days of ICU stay. Age, operation name, preoperative lung injury, no epidural analgesia, and predicted post operative forced expiratory volume in 1 second (ppoFEV1) were the risk factors for prolonged ICU stay, by multivariable analysis (P < 0.05). Risk score, p was derived from the formula: logit(p/[1-p]) = -5.39 + 0.06 x age + 1.12 x operation name(2) + 1.52 x operation name(3) + 1.32 x operation name(4) + 1.56 x operation name(5) + 1.30 x preoperative lung injury + 0.72 x no epidural analgesia - 0.02 x ppoFEV1 [Age in years, operation name(2): pneumonectomy, operation name(3): esophageal cancer operation, operation name(4): completion pneumonectomy, operation name(5): extended operation, preoperative lung injury(+), epidural analgesia(-), ppoFEV1 in %]. CONCLUSIONS: Age, operation name, preoperative lung injury, epidural analgesia, and ppoFEV1 can predict postoperative morbidity in thoracic surgery patients.
