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Related Concept Videos

  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Preoperative Pulmonary Risk Stratification For Noncardiothoracic Surgery: Systematic Review For The American College Of Physicians.
  • Biomedical And Clinical Sciences
  • Oncology And Carcinogenesis
  • Predictive And Prognostic Markers
  • Preoperative Pulmonary Risk Stratification For Noncardiothoracic Surgery: Systematic Review For The American College Of Physicians.

    • Related Experiment Videos

    Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians.

    Gerald W Smetana1, Valerie A Lawrence, John E Cornell

    • 1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. gsmetana@bidmc.harvard.edu

    Annals of Internal Medicine
    |April 19, 2006

    View abstract on PubMed

    Summary
    This summary is machine-generated.

    Identifying key clinical and laboratory factors can help predict postoperative pulmonary complications. This systematic review highlights factors like age, comorbidities, and specific surgical procedures for better risk stratification.

    Related Experiment Videos

    Area of Science:

    • Anesthesiology
    • Pulmonary Medicine
    • Surgical Risk Assessment

    Background:

    • The significance of clinical risk factors for postoperative pulmonary complications (PPCs) and the utility of preoperative testing for risk stratification remain debated.
    • Accurate prediction of PPCs is crucial for optimizing patient outcomes and resource allocation in noncardiothoracic surgery.

    Purpose of the Study:

    • To conduct a systematic literature review on preoperative pulmonary risk stratification methods prior to noncardiothoracic surgical procedures.
    • To identify and evaluate patient- and procedure-related risk factors, as well as laboratory predictors, for PPCs.

    Main Methods:

    • A comprehensive MEDLINE search (1980-2005) and bibliography review identified relevant English-language studies.
    • Studies meeting predefined criteria reported on risk factors and predictors of PPCs after noncardiothoracic surgery.
    • Standardized abstraction instruments were used to extract data on study characteristics, design, quality, and identified risk factors.

    Main Results:

    • Strong evidence supports advanced age, American Society of Anesthesiologists (ASA) class ≥2, functional dependence, COPD, and CHF as patient-related risk factors for PPCs.
    • Significant procedure-related risk factors include aortic aneurysm repair, non-thoracic resective surgery, abdominal surgery, neurosurgery, emergency surgery, general anesthesia, head/neck surgery, vascular surgery, and prolonged procedures.
    • Serum albumin <30 g/L is the only laboratory predictor with strong supporting evidence; preoperative spirometry lacks sufficient evidence for risk stratification.

    Conclusions:

    • Selected clinical factors (e.g., age, ASA class, comorbidities) and laboratory markers (e.g., serum albumin) enable risk stratification for PPCs in noncardiothoracic surgery.
    • Limitations in existing literature include unadjusted risk estimates and potential biases from study design and variable selection, impacting the reliability of multivariable analyses.