Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making

Jensen, Janne Hastrup; Sørensen, Lotte; Mosegaard, Sebastian Breddam; Mechlenburg, Inger

doi:10.1080/09593985.2022.2037795

Cited by 3 publications

(22 citation statements)

References 43 publications

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“…infections within the last year, sternotomy and thoracoabdominal incision were all predictors statistically significantly associated with a higher incidence of PPC in both the development sample 4 and the validation sample (Table 2).…”

Section: Demographics and Comparison With The Ppc Risk Prediction Sco...mentioning

confidence: 99%

“…The distribution of surgical incisions and events of predictors differed between the development sample 4 and the validation sample (Table 2). Some statistically significant associations from the univariate analysis in the development sample were reproduced in the validation sample: repeated lung…”

Section: Demographics and Comparison With The Ppc Risk Prediction Sco...mentioning

confidence: 99%

“… 1 The estimated incidence of PPC is 1%–35% depending on differences in PPC definition, patient population and type of surgical intervention. 2 , 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

“…A Delphi process and a cohort of 339 patients formed the basis for the development of the PPC Risk Prediction Score in accordance with the recommended standards from the PROGnosis RESearch Strategy Partnership (PROGRESS) and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines. 4 , 10 , 16 This work resulted in a prediction score identifying four independent predictors of PPC. 4 …”

Section: Introductionmentioning

confidence: 99%

“… 4 , 10 , 16 This work resulted in a prediction score identifying four independent predictors of PPC. 4 …”

Section: Introductionmentioning

confidence: 99%

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Risk stratification for post‐operative pulmonary complications following major cardiothoracic or abdominal surgery: Validation of the PPC Risk Prediction Score for physiotherapist's clinical decision‐making

Salling

Jensen

Mosegaard

et al. 2023

Clinical Respiratory J

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Introduction Patients undergoing major cardiothoracic or abdominal surgery are at increased risk of developing post‐operative pulmonary complications (PPC), but respiratory physiotherapy can prevent PPC. We have previously developed the PPC Risk Prediction Score to allocate physiotherapists' resources and stratify patients into three risk groups. In this study, we performed a temporal external validation of the PPC Risk Prediction Score. Such validation is rare and adds to the originality of this study. Methods A cohort of 360 patients, admitted to undergo elective cardiothoracic or abdominal surgery, were included. Performance and clinical usefulness of the PPC Risk Prediction Score were estimated through discrimination, calibration and clinical usefulness, and the score was updated. Results The score showed c‐statistics of 0.62. Related to clinical usefulness, a cut point at 8 gave a sensitivity of 0.49 and a specificity of 0.70, whereas a cut point at 12 gave a sensitivity of 0.13 and a specificity of 0.95. Two predictors included in the development sample score, thoraco‐abdominal incision odds ratio (OR) 2.74 (1.12;6.71) and sternotomy OR 2.09 (1.18;3.72), were statistically significantly associated to PPC in the validation sample. Conclusions The score was not able to discriminate between patients with and without PPC; neither was the updated score, but the study identified clinically relevant risk factors for developing PPC.

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Section: Demographics and Comparison With The Ppc Risk Prediction Sco...mentioning

confidence: 99%

Section: Demographics and Comparison With The Ppc Risk Prediction Sco...mentioning

confidence: 99%

“… 1 The estimated incidence of PPC is 1%–35% depending on differences in PPC definition, patient population and type of surgical intervention. 2 , 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 4 , 10 , 16 This work resulted in a prediction score identifying four independent predictors of PPC. 4 …”

Section: Introductionmentioning

confidence: 99%

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Risk stratification for post‐operative pulmonary complications following major cardiothoracic or abdominal surgery: Validation of the PPC Risk Prediction Score for physiotherapist's clinical decision‐making

Salling

Jensen

Mosegaard

et al. 2023

Clinical Respiratory J

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Multimodal prehabilitation and postoperative outcomes in upper abdominal surgery: systematic review and meta-analysis

Amirkhosravi,

Allenson,

Moore

et al. 2024

Sci Rep

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The impact of multimodal prehabilitation on postoperative complications in upper abdominal surgeries is understudied. This review analyzes randomized trials on multimodal prehabilitation with patient and hospital outcomes. MEDLINE, Embase, CINAHL, and Cochrane CENTRAL were searched for trials on prehabilitation before elective (non-emergency) abdominal surgery. Two reviewers independently screened studies, extracted data, and assessed study quality. Primary outcomes of interest were postoperative pulmonary complications (PPCs) and all-cause complications; secondary outcomes included hospital and intensive care length of stay. A meta-analysis with random-effect models was performed, and heterogeneity was evaluated with I-square and Cochran’s Q test. Dichotomous variables were reported in log-odds ratio and continuous variables were presented as mean difference. Ten studies (total 1503 patients) were included. Odds of developing complications after prehabilitation were significantly lower compared to various control groups (− 0.38 [− 0.75– − 0.004], P = 0.048). Five studies described PPCs, and participants with prehabilitation had decreased odds of PPC (− 0.96 [− 1.38– − 0.54], P < 0.001). Prehabilitation did not significantly reduce length of stay, unless exercise was implemented; with exercise, hospital stay decreased significantly (− 0.91 [− 1.67– − 0.14], P = 0.02). Multimodal prehabilitation may decrease complications in upper abdominal surgery, but not necessarily length of stay; research should address heterogeneity in the literature.

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Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

Hong,

Rhee,

Kim

et al. 2023

JCM

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Background: There is a lack of studies on utilising skeletal muscle mass via preoperative lumbar computed tomography or magnetic resonance imaging as a predictor of postoperative complications of posterior lumbar interbody fusion (PLIF) surgery in elderly patients. Methods: Patients aged >65 years who underwent PLIF were enrolled. The sum of the cross-sectional areas of the erector spinae muscles (CSABoth) was presented as the skeletal muscle mass. Postoperative complications were assessed using CSABoth, pulmonary function testing, and prognostic nutritional index (PNI). Results: Patients with postoperative complications showed significantly lower values of CSABoth (median 2266.70 (2239.73–2875.10) mm2 vs. 3060.30 (2749.25–3473.30) mm2, p < 0.001), functional vital capacity, forced expiratory volume at 1 s, and PNI. However, multiple logistic regression analysis identified American Society of Anaesthesiologists Physical Status (ASA PS) I (odds ratio 0.307 (95% confidence interval 0.110–0.852), p = 0.023), ASA PS III (4.033 (1.586–10.254), p = 0.003), CSABoth (0.999 (0.999–1.000), p < 0.001), and postoperative red blood cell (RBC) transfusion (1.603 (1.193–2.152), p = 0.002) as risk factors for postoperative complications after PLIF surgery. Conclusions: CSABoth, ASA PS III, and postoperative RBC transfusion might be used as predictors of postoperative complications after PLIF in patients aged >65 years.

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Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making

Cited by 3 publications

References 43 publications

Risk stratification for post‐operative pulmonary complications following major cardiothoracic or abdominal surgery: Validation of the PPC Risk Prediction Score for physiotherapist's clinical decision‐making

Risk stratification for post‐operative pulmonary complications following major cardiothoracic or abdominal surgery: Validation of the PPC Risk Prediction Score for physiotherapist's clinical decision‐making

Multimodal prehabilitation and postoperative outcomes in upper abdominal surgery: systematic review and meta-analysis

Back Muscle Mass as a Predictor of Postoperative Complications in Posterior Lumbar Interbody Fusion Surgery

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