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Ann Surg. 2000 Aug;232(2):242-53.

Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery. The National Veterans Administration Surgical Quality Improvement Program.

Author information

  • 1Section of General Internal Medicine, University of Illinois College of Medicine, Chicago, Illinois 60612, USA. arozulla@uic.edu

Abstract

OBJECTIVE:

To develop and validate a preoperative risk index for predicting postoperative respiratory failure (PRF).

SUMMARY BACKGROUND DATA:

Respiratory failure is an important postoperative complication.

METHOD:

Based on a prospective cohort study, cases from 44 Veterans Affairs Medical Centers (n = 81,719) were used to develop the models. Cases from 132 Veterans Affairs Medical Centers (n = 99,390) were used as a validation sample. PRF was defined as mechanical ventilation for more than 48 hours after surgery or reintubation and mechanical ventilation after postoperative extubation. Ventilator-dependent, comatose, do not resuscitate, and female patients were excluded.

RESULTS:

PRF developed in 2,746 patients (3.4%). The respiratory failure risk index was developed from a simplified logistic regression model and included abdominal aortic aneurysm repair, thoracic surgery, neurosurgery, upper abdominal surgery, peripheral vascular surgery, neck surgery, emergency surgery, albumin level less than 30 g/L, blood urea nitrogen level more than 30 mg/dL, dependent functional status, chronic obstructive pulmonary disease, and age.

CONCLUSIONS:

The respiratory failure risk index is a validated model for identifying patients at risk for developing PRF and may be useful for guiding perioperative respiratory care.

PMID:
10903604
[PubMed - indexed for MEDLINE]
PMCID:
PMC1421137
Free PMC Article
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