Predictive respiratory complication quotient predicts pulmonary complications in thoracic surgical patients Journal Article
| Authors: | Melendez, J. A.; Barrera, R. |
| Article Title: | Predictive respiratory complication quotient predicts pulmonary complications in thoracic surgical patients |
| Abstract: | Background. This study was designed to develop an accurate preoperative index of prediction of outcome and hospital charges after lung resection with standard available pulmonary tests in a tertiary cancer center. Methods. Sixty-one consecutive patients undergoing pulmonary resections were evaluated. All patients underwent spirometry, carbon monoxide diffusion capacity, split lung function testing, and room air blood gas analysis at rest and after a 2-minute step climb. The thoracic prospective data base and patient charts were reviewed for length of hospitalization, postoperative length of stay, and complications requiring therapy. Logistic regression analysis of the preoperative data, operation and postoperative outcome was used to develop a new postoperative predictive index: the predictive respiratory complication quotient (PRQ). We describe the design of the equation for the probability of serious pulmonary complications, hospital stay, and hospital charges based on PRQ. Results. Ten of 12 patients with a PRQ less than 2,200 suffered serious pulmonary complications of pneumonia, respiratory insufficiency, hypoxemia, and death. Forty-nine patients with a PRQ more than 2,200 did not experience any pulmonary complications. Postoperative length of stay and hospital charges correlated with the PRQ. Conclusions. A construct such as the PRQ may provide a better prediction of outcome than its individual parts. We identified an important underlying relationship between intensive care unit stay, hospital stay and charges, and our index. A PRQ of less than 2,200 was associated with an increased risk of pulmonary complications and mortality. |
| Keywords: | adult; human tissue; treatment outcome; aged; middle aged; retrospective studies; major clinical study; preoperative evaluation; lung resection; logistic models; lung neoplasms; pneumonectomy; oxygen; lung cancer; algorithms; pneumonia; intensive care; postoperative complication; cause of death; length of stay; hospitalization; probability; lung; forecasting; respiration; forced expiratory volume; lung function test; respiratory insufficiency; respiratory failure; carbon dioxide; surgical patient; carbon monoxide; lung diseases; pulmonary diffusing capacity; spirometry; databases; exertion; humans; prognosis; human; male; female; priority journal; article; rest; anoxemia; hospital charges |
| Journal Title: | Annals of Thoracic Surgery |
| Volume: | 66 |
| Issue: | 1 |
| ISSN: | 0003-4975 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 1998-07-01 |
| Start Page: | 220 |
| End Page: | 224 |
| Language: | English |
| DOI: | 10.1016/s0003-4975(98)00319-1 |
| PUBMED: | 9692468 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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