PREDICTORS OF POSTOPERATIVE ATELECTASIS PNEUMONIA

描述：(改编自调查人员摘要)术后肺部 并发症(PPC)很常见，并与发病率增加有关， 死亡率、住院时间和资源利用。肺不张 肺炎占报告的PPC的80%。这样做的目的是 这项研究是为了开发预测模型来分层临床上的风险。 严重的肺不张和/或肺炎 成人腹部和心胸外科手术现有临床资料 人口。长期目标是开发预测模型(S)，用于 指导手术前后肺部护理的临床设置。 这项研究的主要目的是开发、比较和验证模型以 预测临床显著肺不张和/或肺炎的风险 腹部或心胸手术后评估组合 手术过程中不同时间段的风险因素 关爱的插曲。次要目的是比较临床上 严重肺不张和/或腹部和/或肺炎 心胸外科手术和术后患者之间的住院时间 谁会患上这些并发症，哪些人不会。四所院校 将用于数据收集，目标人群是成年人 正在接受择期腹部或心胸手术 麻醉。目标样本量为三年内的1500名受试者 句号。将使用多标准定义来衡量以下方面的结果 临床上有意义的肺不张和肺炎，不要高估 发病率。引起兴趣的风险因素有：年龄增长、身体受损 术前认知功能水平，慢性肺部疾病病史， 既往并存疾病，低或高体重指数(BMI)增加 术前住院时间、吸烟史、术前无病史 呼吸教育，高麻醉物理风险状态(ASA)，增加 麻醉持续时间、手术类型和位置、手术切开 气管插管/机械通气的方向和长度、持续时间 麻醉后时期，疼痛处理，术后活动， 给予H2阻滞剂/抗酸剂和鼻胃管。 将在手术前和每天收集每个受试者的数据 直到医院出院。将使用Logistic回归分析来确定 检验临床上有意义的单变量效应的危险因素 肺不张与肺炎的关系及其多变量的比较 模特们。将评估模型的实用性和拟合度。一个 模型验证将采用分裂样本技术。

DESCRIPTION: (Adapted from investigator's abstract) Postoperative pulmonary complications (PPCs) are frequent and associated with increased morbidity, mortality, hospital length of stay and resource utilization. Atelectasis and pneumonia account for >80% of reported PPCs. The objective of this study is to develop predictive models for stratifying the risk of clinically significant atelectasis and/or pneumonia using readily accessible or existing clinical data in an adult abdominal and cardiothoracic surgical population. The long term goal is to develop predictive model(s) for use in the clinical setting to guide preoperative and postoperative pulmonary care. The primary aim of this study is to develop, compare and validate models to predict the risk of clinically significant atelectasis and/or pneumonia following abdominal or cardiothoracic procedures by assessing combinations of risk factors available at differing time periods during the surgical episode of care. Secondary aims are to compare the incidence of clinically significant atelectasis and/or pneumonia following abdominal and cardiothoracic procedures and postoperative length of stay between patients who develop these complications and those who do not. Four institutions will be utilized for data collection and the target population is adults who are undergoing elective abdominal or cardiothoracic procedures with general anesthesia. The target sample size is 1500 subjects over a three year period. Multi-criteria definitions will be used to measure the outcomes of clinically significant atelectasis and pneumonia as not to overestimate the incidence. The risk factors of interest are: increased age, impaired preoperative level of cognitive function, history of chronic lung disease, preexisting comorbid diseases, low or high body mass index (BMI), increased preoperative length of stay, smoking history, absence of preoperative respiratory education, high anesthesia physical risk status (ASA), increased duration of anesthesia, type and location of surgical procedure, incision direction and length, duration of intubation/mechanical ventilation in the postanesthesia period, pain management, postoperative mobility, administration of H2 blockers/antacids and presence of a nasogastric tube. Data will be collected on each subject prior to surgery and on a daily basis until hospital discharge. Logistic regression analysis will be used to examine the risk factors for univariate effects on clinically significant atelectasis and pneumonia and to develop and compare the multivariate models. Models will be evaluated for utility and goodness-of-fit. A split-sample technique will be used for model validation.