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Risk Assessment of Perioperative Respiratory Adverse Events and Validation of the COLDS Score in Children with Upper
Hyo Sung Kim1, Young Sung Kim1, Byung Gun Lim1
1Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea.
Insights
The COLDS score effectively predicts perioperative respiratory adverse events (PRAEs) in children with upper respiratory tract infections (URTIs) undergoing surgery. This validated tool aids in pre-anesthetic risk assessment for pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Respiratory Medicine
- Risk Assessment Tools
Background:
- Children face elevated risks of upper respiratory tract infections (URTIs), increasing susceptibility to perioperative respiratory adverse events (PRAEs).
- Accurate pre-anesthetic risk assessment is crucial for mitigating PRAEs in pediatric surgical patients.
Purpose of the Study:
- To validate the COLDS score as a reliable tool for predicting PRAEs in children undergoing elective surgery.
- To assess the predictive capability of the COLDS score in pediatric patients with URTI.
Main Methods:
- Retrospective analysis of 6252 children under 18 undergoing elective surgery.
- Logistic regression and ROC curve analysis (AUC) to evaluate COLDS score predictive accuracy.
- Propensity-matched comparison to assess the contribution of COLDS components.
Main Results:
- 158 children had recent URTI, with 34 reported PRAEs.
- COLDS score, younger age, and current URTI symptoms were significant predictors of PRAEs.
- ROC analysis yielded an AUC of 0.652 (p=0.007) with a cut-off value of 12.5 for the COLDS score.
Conclusions:
- The COLDS score is a validated tool for assessing PRAE risk in children with URTI undergoing elective surgery.
- The study confirms that the COLDS score, younger age, and URTI symptoms are key risk factors for PRAEs.
Abstract:
Background and objectives: Children are at greater risk of upper respiratory tract infection (URTI), which can pose a higher risk of perioperative respiratory adverse events (PRAEs), than adults. The purpose of this study was to validate the COLDS score as a pre-anesthetic risk assessment tool for predicting the possibility of PRAEs. Materials and methods: Children aged under 18 years and undergoing elective surgery were retrospectively included. Logistic regression analysis and the area under the receiver-operating characteristic (ROC) curve (AUC) were used to estimate the ability of the COLDS score to predict PRAEs. Propensity-matched comparison was evaluated using the cut-off value from the ROC curve. Results: Among the 6252 children, 158 children had a recent URTI and 34 cases of PRAEs were reported. Age, current symptoms, and COLDS score were found to be significant variables in predicting PRAEs. From the ROC curve, values of 0.652 (p = 0.007) for AUC and 12.5 for the cut-off value of the COLDS score were calculated. Propensity-matched comparison revealed that each and every component of COLDS contributed to the higher COLDS score group. In addition to higher COLDS score, younger age and current URTI symptoms were found to be significant risk factors for PRAEs. Conclusions: This study validated the predictive power of COLDS score as a risk assessment tool for children with URTI undergoing elective surgery under general anesthesia.
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