Prediction of postoperative pulmonary complications on the basis of preoperative risk factors in patients who had undergone coronary artery bypass graft surgery.
OBJECTIVE
Pulmonary complications are among the most frequently reported complications after coronary artery bypass graft (CABG) surgery. However, the risks of postoperative pulmonary complications (PPCs) are not equal for all patients. The aim of this study was to develop a model, based on preoperative factors, for classifying patients with high and low risks for PPCs in order to implement tailored interventions.


METHODS
Postoperative pulmonary complications were examined in 117 adult patients who had undergone elective CABG surgery at the University Medical Centre Utrecht, Utrecht, the Netherlands. The presence of preoperative risk factors (N=12) that have been described in the literature was noted for each patient. A risk model was developed by use of logistic regression analysis.


RESULTS
Preoperative risk factors for developing PPCs were an age of (>/=70 years, productive cough, diabetes mellitus, and a history of cigarette smoking. Protective factors against the development of PPCs were a predicted inspiratory vital capacity of (>/=75% and a predicted maximal expiratory pressure of (>/=75%. These risk and protective factors were included in the model (sensitivity=87% and specificity=56%), and a sum score for its clinical use was generated.


CONCLUSIONS
Six factors that can be determined easily before surgery, with need for only simple pulmonary testing, can provide a model for identifying patients at risk of developing PPCs after CABG surgery.
Hulzebos
Erik H J
EH
Rudolf Magnus Institute for Neuroscience, Department of Rehabilitation, Section of Physical Therapy, University Medical Center Utrecht, Room F 00.810, PO Box 85500, 3508 GA Utrecht, The Netherlands. h.hulzebos@pmbr.azu.nl
Van Meeteren
Nico L U
NL
De Bie
Rob A
RA
Dagnelie
Pieter C
PC
Helders
Paul J M
PJ
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000534:rehabilitation; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity