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Combining Spirometry and the ARISCAT Respiratory Risk Assessment Can Improve Postoperative Outcomes and Reduce

Yolanda Mares-Gutiérrez1,2, Adrián Martínez-González3, Guillermo Salinas-Escudero4

  • 1Pulmonary Physiology Department, Hospital General de México Dr. Eduardo Liceaga, C.P. 06720 Mexico City, Mexico.

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Summary
This summary is machine-generated.

Preoperative spirometry, combined with the ARISCAT risk assessment, significantly reduces postoperative complications and mortality in surgical patients. Guidelines should include spirometry for moderate to high-risk individuals.

Keywords:
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Area of Science:

  • Anesthesiology
  • Pulmonology
  • Surgical Risk Assessment

Background:

  • Current Mexican guidelines limit preoperative spirometry to patients with known pulmonary disease.
  • Preoperative evaluation aims to identify risks and improve surgical outcomes.
  • The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) tool stratifies surgical risk.

Purpose of the Study:

  • To compare postoperative complications (POC), mortality, and risk factors in patients who did or did not undergo preoperative spirometry.
  • To evaluate the impact of spirometry based on ARISCAT risk levels.

Main Methods:

  • Observational, retrospective, comparative study of 2059 patients (2013-2017) at the General Hospital of Mexico.
  • Patients categorized into ARISCAT with spirometry (n=1306) and ARISCAT without spirometry (n=753) groups.
  • Statistical analyses included Chi-square, Fisher's exact test, Student's t-tests, and logistic regression.

Main Results:

  • The spirometry group had 11% POC versus 48% in the non-spirometry group.
  • High-risk patients without spirometry had 18% mortality, compared to 0.4% with spirometry.
  • Logistic regression confirmed that omitting spirometry increased POC and mortality risk.

Conclusions:

  • Combining preoperative spirometry with ARISCAT assessment is linked to lower POC and mortality.
  • Clinical guidelines in Mexico should consider recommending preoperative spirometry for moderate and high-risk ARISCAT patients.