Development of a prediction model for postoperative pneumonia A multicentre prospective observational study
| Authors |
RUSSOTTO V SABATE S CANET J LANGERON O DE Abreu MG GALLART L BELDA FJ PELOSI P HOEFT A MAZO V LEVA B BURIMI J HALEFI T HOXHA A PILIKA K SELMANI I DAOUT V GAUTHIER C KAHN D MOMENI M WATREMEZ C STRAUS S DJONOVIC-MANOVIC D JUROS-ZOVKO M KOMEN-USLJEBRKA H ORLIC V STUCK I BALAKOVA L KOSINOVÁ Martina KŘIKAVA Ivo ŠTOUDEK Roman ŠTOURAČ Petr ZADRAZILOVA K JANVEKAR S KARJAGIN J ROIVASSEPP K SORMUS A CUVILLON P IBANEZ-ESTEVE C RAUX M NICOLAS-ROBIN A WINTER A BRUNIER M ENGELHARD K FELDMANN RL LINDEMANN R MAUFF S SEBASTIANI A ZAMPERONI C HOEFT A KESSLER F WITTMANN M BLUTH T GULDNER A KISS T BRAZ K RUSZKAI C MICAGLIO M ORI C PAROTTO M PERSONA P GIUSEPPE C CARNESECCHI P LAZZERONI D LORENZI I CASTELLANI G SANCES D SPANO G TREDICI S VEZZOLI D BRUNETTI I DI Noto A GRATAROLA A MOLIN A MONTAGNANI L PELLERANO G PELOSI P FUSARI M CAMICI L GUZZETTI L MARANGONI F SEVERGNINI P DI Mauro P RAPIDO F TOMMASINO C NEMME I NEMME J BLIEKA J BORODICIENE J BUDRYTE B KARBONSKIENE A KIUDULAITE I MILIESKAITE E RASIMAVICIUTE R SIREVICIENE U STASAITYTE R USAS E ZARSKIENE G KONTRIMAVICIUTE E SIPYLAITE J TOMKUTE G BARDEA P KLOP M KOCH M BOZILOW D GOCH R BONIFACIO J MARQUES S RALHA TTD ALVES D CARVALHO I PARENTE JSD TOME S CARMONA C COSTA M LINA M SIERRA S BALCAN A CINDEA I GHERGHINA VI GRASA C COPOTOIU R COPOTOIU SM KOVACS J SZEDERJESI J THEIL A FILIPESCU D GRYTSAN A KAPKAN T ROSTOVTSEV S YUSHKOVA A CALDERON R CACHO E MARGINET C MONEDERO P YEPES MJ MINANA JME GIL MG PORTOLES GR LISI A PEREZ G POCH N QUINTEROS MRA BOSCH CF LLOBERA JT SIERRA P MATUTE M DOMINGUEZ AA ARGUIS MJ BELDA I CARRERO E MORENO J ROVIRA I UBRE M CASTILLO R HERRERO S LUJAN MTB CARBONELL J GENCHEVA G GUTIERREZ A LLORENS J MACHADO S LLOBELL F DP Martin GARCIA-MIGUEL FJ GARCIA AP COMPANY R IDRISSI AA CANAVERAS JD MARTINEZ JAN MARTINEZ EP GARCIA ES BELLA JV ALDANA II CAMPOS JM VAAMONDE XP TORRA M ARROYO R CABRERA JC CORDOBES JC GALLART L ROJO A SANTIVERI FJ GONZALEZ M JIMENEZ A JIMENEZ Y MARTI A MORET E NUNEZ MR VELASCO J CALDERON A GONZALEZ M GONZALEZ O ANCHUELO AH LOPEZ E SANCHEZ E ZANGO BA CORRAL FJG EM Mena ROCA AP SOTO RFRA QUINTANA B LLEVOT JMR CAMUS MMW BLANCO AP RUIZ AL FEIJOO JR GARIJO EC CUENCA JB BINIMELIS MJB GRIGOROV I AGUILAR JL CLANCHET MDN VINAS EG MUNIZ SM MORA VM BAUZA FM AGUADO SN VIDAL MO GOZALO MLP MARIN MS LOPEZ MCS MAINO P YEVSTRATOV YE KUCUKGONCU S SENTURK NM ULKE ZS |
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| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | European Journal of Anaesthesiology |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1097/EJA.0000000000000921 |
| Description | BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 degrees C; leucocyte count more than 12 000 mu l(-1). RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO(2) values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572). CONCLUSION We identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia. |