Superiority of respiratory failure risk index in prediction of postoperative pulmonary complications after digestive surgery in Japanese patients.
Superiority of respiratory failure risk index in prediction of postoperative pulmonary complications after digestive surgery in Japanese patients.
复制标题
呼吸衰竭风险指数在预测日本消化外科患者术后肺部并发症中的优越性。
DOI：
10.1016/j.resinv.2014.12.004
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发表时间：
2015
影响因子：
3.1
通讯作者：
I. Narita
中科院分区：
文献类型：
--
作者：
S. Hokari;Y. Ohshima;H. Nakayama;Ryoko Suzuki;Tomosue Kajiwara;T. Koya;H. Kagamu;T. Takada;E. Suzuki;I. Narita
背景西方国家提出了几种多因素风险指数来识别术后肺部并发症（PPC）高风险患者。然而，对于如何评估PPC的风险以及应针对日本患者采用哪些多因素风险指数尚未达成共识。本研究旨在阐明风险指数的效用，以预测PPC以下消化道surgery in Japanese patients.MethodsWe回顾性分析了892例患者接受消化道手术全麻下在新泻大学医学和牙科医院2009年1月至2011年3月。PPC定义为术后呼吸衰竭和术后肺炎。我们计算了三个风险指数：呼吸衰竭风险指数（RFRI），术后肺炎风险指数和PPC风险评分，并将其在PPC组和非PPC组之间进行比较。采用受试者工作特征（ROC）曲线分析比较每个index.ResultsPPC开发的55例（6.2%）的有用性。PPC组各项危险指标均显著高于非PPC组。风险评分的类别分类显示出显著的增加PPC发生率的趋势。在ROC分析中，RFRI的曲线下面积为0.762（95%CI 0.697-0.826），这是这些index.ConclusionsMultifactorial风险指数之间观察到的最高值是有用的工具，用于识别日本患者在消化道手术后发展PPC的高风险。在本研究评估的风险指标中，RFRI可能是预测PPC最准确的指标。
BackgroundSeveral multifactorial risk indexes have been proposed by Western countries for identifying patients at a high risk of developing postoperative pulmonary complications (PPC). However, there is no consensus on how to evaluate the risk of PPC and what multifactorial risk index should be adapted for Japanese patients. This study aimed at clarifying the utility of risk indexes to predict PPC following digestive surgeries in Japanese patients.MethodsWe retrospectively analyzed 892 patients who underwent digestive surgeries under general anesthesia in Niigata University Medical and Dental Hospital between January 2009 and March 2011. PPC was defined as postoperative respiratory failure and postoperative pneumonia. We calculated three risk indexes; respiratory failure risk index (RFRI), postoperative pneumonia risk index, and PPC risk score, and compared them between the PPC and the non-PPC group. A receiver operating characteristic (ROC) curve analysis was employed to compare the usefulness of each index.ResultsPPC developed in 55 patients (6.2%). All risk indexes were significantly higher in the PPC group than non-PPC group. The category classification of the risk scores demonstrated a significant tendency to increase the incidence rate of PPC. In the ROC analysis, the area under the curve for RFRI was 0.762 (95% CI 0.697-0.826), which was the highest value observed among these indexes.ConclusionsMultifactorial risk indexes are useful tools for identifying Japanese patients at a high risk of developing PPC following digestive surgeries. Of the risk indexes evaluated in this study, RFRI is potentially the most accurate in predicting PPC.