title: Comparison of recognition tools for postoperative pulmonary complications following thoracotomy.
abstract: OBJECTIVE
  To evaluate the recognition of postoperative pulmonary complications (PPC) following thoracotomy and lung resection using three PPC scoring tools.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Regional thoracic centre.
  
  
  METHODS
  One hundred and twenty-nine consecutive thoracotomy and lung resection patients (October 2007 and April 2008).
  
  
  METHODS
  PPC assessment was performed on a daily basis using three sets of criteria described by Brooks-Brunn, Gosselink et al. and Reeve et al.: the Brooks-Brunn Score (BBS), Gosselink Score (GS) and Melbourne Group Scale (MGS), respectively. The results were compared with treatment for PPC and clinical outcomes including mortality, postoperative length of stay and high dependency unit length of stay.
  
  
  RESULTS
  PPC frequency was 13% (17/129) with the MGS, 6% (8/129) with the GS and 40% (51/129) with the BBS. The clinically observed incidence of treated (requiring antibiotic therapy or bronchoscopy) PPC was 12% (16/129).
  
  
  CONCLUSIONS
  PPC treatment following thoracotomy is common. Of the three scoring tools, the MGS outperforms the BBS and the GS in terms of PPC recognition following thoracotomy and lung resection. Patients with a PPC-positive MGS score have a worse outcome as defined by mortality, high dependency unit length of stay and postoperative length of stay. The MGS is an easy-to-use multidisciplinary scoring tool, but further work is required into its use in minimally invasive surgery and in targeting high-risk groups for therapy.
authors: Department of Thoracic Surgery, Heart of England NHS Foundation Trust, Birmingham, UK. paula.agostini@heartofengland.nhs.uk
authors: P
authors: P
authors: Agostini
authors: B
authors: B
authors: Naidu
authors: H
authors: H
authors: Cieslik
authors: S
authors: S
authors: Rathinam
authors: E
authors: E
authors: Bishay
authors: M S
authors: MS
authors: Kalkat
authors: P B
authors: PB
authors: Rajesh
authors: R S
authors: RS
authors: Steyn
authors: S
authors: S
authors: Singh
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*; D012307:Risk Factors; D013908:Thoracotomy / Q000009:adverse effects*