Do ARISCAT Scores Help to Predict the Incidence of Postoperative Pulmonary Complications in Elderly Patients After Upper Abdominal Surgery? An Observational Study at a Single University Hospital.

2021 ◽  
Author(s):  
Jitsupa Nithiuthai ◽  
Arunotai Siriussawakul ◽  
Namtip Triyasunant ◽  
Rangsinee Junkai ◽  
Nutthakorn Horugsa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Assessment Tool ◽  
Risk Groups ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Surgical Patients ◽  
Postoperative Pulmonary Complications ◽  
Average Hospital ◽  
Hospital Stays ◽  
Upper Abdominal

Abstract BackgroundThe incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais.MethodsA retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores.ResultsIn all, 1,100 elderly postoperative patients were analyzed. Their mean age was 73.62 years, and 48.5% were male. The incidence of PPCs was 7.72%, with the most common being pleural effusion, atelectasis, and pneumonia. The average hospital and intensive care unit stays of the PPC patients were significantly longer than those without PPC (25.35 versus 7.30 days, with p < 0.0001; and 8.36 versus 2.84 days, with p 0.010, respectively). Almost 90% of the PPC patients had intermediate-to-high ARISCAT scores, with an average of 43.15 ± 13.58.ConclusionsPPCs are common in elderly patients and are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of geriatric Thai patients into PPC risk groups. Its usage might help to raise healthcare awareness and improve the perioperative management of elderly Thai patients. Moreover, the ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.

scholarly journals Do ARISCAT scores help to predict the incidence of postoperative pulmonary complications in elderly patients after upper abdominal surgery? An observational study at a single university hospital

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jitsupa Nithiuthai ◽  
Arunotai Siriussawakul ◽  
Rangsinee Junkai ◽  
Nutthakorn Horugsa ◽  
Sunit Jarungjitaree ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Assessment Tool ◽  
Area Under The Curve ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Surgical Patients ◽  
Postoperative Pulmonary Complications ◽  
Duration Of Surgery ◽  
Upper Abdominal

Abstract Background The incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence and risk factors of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais. Methods A retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores. Results In all, 1100 elderly postoperative patients were analyzed. Their mean age was 73.6 years, and 48.5% were male. Nearly half of their operations were laparoscopic cholecystectomies. The incidence of PPCs was 7.7%, with the most common being pleural effusion, atelectasis, and pneumonia. The factors associated with PPCs were preoperative oxygen saturation less than 96% (OR = 2.6, 1.2–5.5), albumin level below 3.5 g/dL (OR = 1.7, 1.0–2.8), duration of surgery exceeding 3 h (OR = 2.0, 1.0–4.2), and emergency surgery (OR = 2.8, 1.4–5.8). There was a relationship between ARISCAT score and PPC incidence, with a correlation coefficient of 0.226 (P < 0.001). The area under the curve was 0.72 (95% CI, 0.665–0.774; P < 0.001). Conclusions PPCs are common in elderly patients. They are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of Thai patients into PPC risk groups. The ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.

scholarly journals Study of risk, incidence and mortality associated with postoperative pulmonary complications using assess respiratory risk in surgical patients in catalonia score

2019 ◽  
Vol 6 (9) ◽  
pp. 3215 ◽  
Author(s):  
Kedar M. Tilak ◽  
Manjusha M. Litake ◽  
Krupa V. Shingada
Keyword(s):  
High Risk ◽  
Care Center ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Risk Groups ◽  
Pulmonary Complications ◽  
Surgical Patients ◽  
Risk Category ◽  
Postoperative Pulmonary Complications ◽  
Incidence And Mortality

Background: Postoperative pulmonary complications (PPCs) are one of the major complications that are seen in patients undergoing surgeries and are also a significant cause of increased duration of hospital stay and mortality. Owing to their high incidence the present study was done to assess the risk and incidence of PPCs using the assess respiratory risk in surgical patients in catalonia (ARISCAT) score and to observe the mortality related to PPCS.Methods: The study was done at a tertiary care center over a period of three month and 150 patients were involved. The patients were the categorized into three risk groups and were observed for development of any PPCs.Results: Out of the 150 patients that were studied, 29 developed some form of PPC. 21 out of these 29 (72.41%) patients were from the high-risk category. 11 out of the 29 patients died in a span of 30 days. Pneumonia was seen to be the most common PPC.Conclusions: ARISCAT score can be useful as a preoperative evaluation tool to classify patients into risk groups and predict the development of PPC in the high-risk groups and to take measures to reduce the risk of PPCs. We conclude from our study that anemia, emergency surgery and surgery with duration of more than 3 hours were significant factors contributing to both the incidence and mortality of PPCs irrespective of the risk group. 

Bleeding after surgery and application bleeding assessment tool to surgical patients in Hanoi Medicine University Hospital

2021 ◽  
Vol 25 (2) ◽  
pp. 94-101
Author(s):  
Thi Minh Khue Nguyen ◽  
Quang Tung Nguyen
Keyword(s):  
Predictive Value ◽  
Assessment Tool ◽  
Bleeding Risk ◽  
University Hospital ◽  
Surgical Patients ◽  
Risk Of Bleeding ◽  
Patients At Risk ◽  
Abnormal Bleeding ◽  
Medical University ◽  
Bleeding History

Objectives: Describe bleeding characteristics and evaluate the correlation between surgical-related bleeding and bleeding risk according by ISTH – BATs. Methods: Research was conducted on 340 surgical patients at Hanoi Medical University Hospital. Results: The percentage of patients with bleeding during and after surgery is 13.5%. The proportion of patients at risk of bleeding according to BATs is 1.8%. There was a correlation between bleeding risk according to ISTH - BAT with bleeding status during and after surgery with p = 0.004. The positive predictive value of ISTH - BATs is 66.7%, negative predictive value is 87.4%, the sensitivity is 8.7%, the specificity is 99.3%. Conclusions: Surgery has a high risk of abnormal bleeding. Bleeding history has important implications in assessing bleeding risk during and after surgery. The ISTH - BATs is a bleeding history assessment tool that can be used to assess the risk of bleeding before surgery.

scholarly journals Pulmonary Complications after Surgery for Rectal Cancer in Elderly Patients: Evaluation of Laparoscopic versus Open Approach from a Multicenter Study on 477 Consecutive Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Marco Milone ◽  
Ugo Elmore ◽  
Andrea Vignali ◽  
Alfredo Mellano ◽  
Nicola Gennarelli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Rectal Surgery ◽  
Laparoscopic Group ◽  
Pulmonary Complications ◽  
Open Approach ◽  
Postoperative Pulmonary Complications ◽  
Old Patients ◽  
The Impact

Aim. To evaluate the impact of open or laparoscopic rectal surgery on pulmonary complications in elderly (>75 years old) patients. Methods. Data from consecutive patients who underwent elective laparoscopic or open rectal surgery for cancer were collected prospectively from 3 institutions. Pulmonary complications were defined according to the ACS/NSQUIP definition. Results. A total of 477 patients (laparoscopic group: 242, open group: 235) were included in the analysis. Postoperative pulmonary complications were significantly more common after open surgery (8 out of 242 patients (3.3%) versus 23 out of 235 patients (9.8%); p=0.005). In addition, PPC occurrence was associated with the increasing of postoperative pain (5.04 ± 1.62 versus 5.03 ± 1.58; p=0.001) and the increasing of operative time (270.06 ± 51.49 versus 237.37 ± 65.97; p=0.001). Conclusion. Our results are encouraging to consider laparoscopic surgery a safety and effective way to treat rectal cancer in elderly patients, highlighting that laparoscopic surgery reduces the occurrence of postoperative pulmonary complications.

The Prediction of Postoperative Pulmonary Complications in the Elderly Patients

1997 ◽  
Vol 44 (2) ◽  
pp. 321
Author(s):  
Kyong Duk Suh ◽  
Yu Seong Jeong ◽  
Bok Kyoo Kam ◽  
Jong Myeong Lee ◽  
Dong Huh ◽  
...  
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications
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