Cardiopulmonary risk index does not predict complications after thoracic surgery Journal Article

Authors: Melendez, J. A.; Arslan Carlon, V.
Article Title: Cardiopulmonary risk index does not predict complications after thoracic surgery
Abstract: Study objective: The preoperative cardiopulmonary risk index (CPRI) is a multifactorial index intended to predict postoperative outcome after thoracic surgery. It combines cardiac and pulmonary information into one parameter that ranges from 1 to 10, with 10 being the worst. A CPRI ≤4 has been advocated as an effective predictor of postoperative pulmonary and cardiac complications. This study prospectively evaluates the predictive value of CPRI in a large population of patients undergoing thoracic surgery. Design: We performed prospective calculation of CPRI in patients about to undergo thoracic surgery. Postthoracic surgery occurrence of pneumonia, atelectasis, arrhythmias, congestive heart failure, respiratory failure requiring therapy, or death occurring within 30 days of surgery was compared with preoperative CPRI and its components. Patients and participants: One hundred eighty consecutive patients, aged 15 to 87 years, were studied. Interventions: Operations performed included 114 lobectomies, 35 wedge resections, 19 pneumonectomies, 5 pleurectomies, 5 lymph node dissections, 1 thoracic wall resection, and 1 paravertebral tumor resection. Measurements and results: Twenty-seven percent of patients experienced complications. CPRI and its components did not predict complications, deaths, or the number of in- hospital days. We found a CPRI ≤4 to be a moderate predictor of outcome for patients undergoing pneumonectomy (n=19). It correctly identified four of nine postpneumonectomy complications. Conclusion: The preoperative CPRI and its components are inadequate predictors of medical complications after thoracic surgery in a general population. In the subgroup of patients undergoing pneumonectomy, the index may be of some value in forecasting outcome.
Keywords: adolescent; adult; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; lymph node excision; prospective studies; lung resection; pneumonectomy; risk factors; prediction; risk factor; pneumonia; postoperative complication; postoperative complications; cause of death; length of stay; spinal neoplasms; forecasting; outcome; outcomes research; atelectasis; heart arrhythmia; evaluation studies; thorax surgery; pleura; congestive heart failure; respiratory insufficiency; respiratory failure; thoracic surgical procedures; heart diseases; lung diseases; thoracic surgery; heart failure, congestive; arrhythmia; humans; human; male; female; priority journal; article
Journal Title: Chest
Volume: 114
Issue: 1
ISSN: 0012-3692
Publisher: American College of Chest Physicians  
Date Published: 1998-07-01
Start Page: 69
End Page: 75
Language: English
PUBMED: 9674449
PROVIDER: scopus
DOI: 10.1378/chest.114.1.69
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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