Document Detail


Accuracy of the preoperative assessment in predicting pulmonary risk after nonthoracic surgery.
MedLine Citation:
PMID:  12598217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We examined the accuracy of preoperative assessment in predicting postoperative pulmonary risk in a prospective cohort of 272 consecutive patients referred for evaluation before nonthoracic surgery. Outcomes were assessed by an independent investigator who was blinded to the preoperative data. There were 22 (8%) postoperative pulmonary complications. Statistically significant predictors of pulmonary complications (all p < or = 0.005) were as follows: hypercapnea of 45 mm Hg or more (odds ratio, 61.0), a FVC of less than 1.5 L/minute (odds ratio, 11.1), a maximal laryngeal height of 4 cm or less (odds ratio, 6.9), a forced expiratory time of 9 seconds or more (odds ratio, 5.7), smoking of 40 pack-years or more (odds ratio, 5.7), and a body mass index of 30 or more (odds ratio, 4.1). Multiple regression analyses revealed three preoperative clinical factors that are independently associated with pulmonary complications: an age of 65 years or more (odds ratio, 1.8; p = 0.02), smoking of 40 pack-years or more (odds ratio, 1.9; p = 0.02), and maximum laryngeal height of 4 cm or less (odds ratio, 2.0; p = 0.007). Thus, preoperative factors can identify those patients referred to pulmonologists or internists who are at increased risk for pulmonary complications after nonthoracic surgery.
Authors:
Finlay A McAlister; Nadia A Khan; Sharon E Straus; Miltiadis Papaioakim; Bruce W Fisher; Sumit R Majumdar; Ognjen Gajic; Malcolm Daniel; George Tomlinson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2002-12-04
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  167     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-24     Completed Date:  2003-03-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  741-4     Citation Subset:  AIM; IM    
Affiliation:
Division of General Internal Medicine, University of Alberta, Edmonton, Canada. finlay.mcalister@ualberta.ca
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Body Mass Index
Cohort Studies
Female
Humans
Hypercapnia / complications
Lung Diseases / epidemiology*,  etiology
Male
Middle Aged
Odds Ratio
Physical Examination
Postoperative Complications / epidemiology*,  etiology
Prognosis
Prospective Studies
Regression Analysis
Respiratory Function Tests
Risk Factors
Sex Factors
Smoking / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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