Francis Whalen, MD
How well does a 5-item calculator predict risk for postoperative respiratory failure (PRF)?
2 cohort studies, 1 for derivation (2007 dataset) and 1 for validation (2008 dataset).
American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files based on participants at 183 (derivation cohort) and 211 (validation cohort) academic and community hospitals in the USA.
468 795 patients who had an eligible surgery in derivation (n = 211 410, mean age 55 y, 57% women) and validation (n = 257 385) cohorts.
A model of 21 preoperative and perioperative variables was sequentially reduced to make the model practical without significant loss of discrimination ability. The result was a 5-item risk calculator* based on type of surgery, emergency case, dependent functional status, preoperative sepsis, and American Society of Anesthesiologists class.
PRF (unplanned perioperative or postoperative intubation, postoperative reintubatation once extubated, or required > 48 h postoperative mechanical ventilation) ≤ 30 days after surgery.
PRF occurred in 3.1% of the derivation cohort and 2.6% of the validation cohort. The c-index for discrimination of risk using the 5-item risk calculator was 0.894 in the derivation cohort and 0.897 in the validation cohort.
A 5-item calculator predicted risk for postoperative respiratory failure.
Francis Whalen. A 5-item calculator predicted risk for postoperative respiratory failure. Ann Intern Med. 2012;156:JC5–13. doi: 10.7326/0003-4819-156-10-201205150-02013
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Published: Ann Intern Med. 2012;156(10):JC5-13.
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