Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making.
Major cardiothoracic or abdominal surgery can lead to the development of postoperative pulmonary complications (PPC), associated with increased morbidity and prolonged length of hospital stay. Preventive chest physiotherapy is routinely provided, but optimization of treatment strategies is needed to...
| Publicado en: | Physiotherapy Theory & Practice Vol. 39; no. 6; pp. 1305 - 1317 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jun2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=163915363&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 163915363 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09593985 BCJ jtl: Physiotherapy Theory & Practice issn: 09593985 maglogo: Y pubinfo: dt: Jun2023 vid: 39 iid: 6 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 163915363 155493930 163915363 163915363 10.1080/09593985.2022.2037795 163915363 ppf: 1305 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Risk Stratification for Postoperative Pulmonary Complications following Major Cardiothoracic and Abdominal Surgery – development of the PPC Risk Prediction Score for Physiotherapists Clinical Decision-making. aug: au: Jensen, Janne Hastrup Sørensen, Lotte Mosegaard, Sebastian Breddam Mechlenburg, Inger affil: Department of Physical and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark sug: subj: Surgery, Lung Adverse Effects Postoperative Complications Prevention and Control Cardiac Surgery Adverse Effects Thoracic Surgery Adverse Effects Surgery, Digestive System Adverse Effects Postoperative Complications Risk Factors Risk Assessment Physical Therapists Psychosocial Factors Decision Making, Clinical Preoperative Period Human Aged, 80 and Over Aged Male Female Morbidity Length of Stay Prospective Studies Nonexperimental Studies Outcome Assessment Logistic Regression Odds Ratio Adult Middle Age Delphi Technique Descriptive Statistics Chi Square Test Unpaired T-Tests Comparative Studies Wilcoxon Rank Sum Test Academic Medical Centers Data Analysis Software ROC Curve Confidence Intervals Aged, 80 & over Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Major cardiothoracic or abdominal surgery can lead to the development of postoperative pulmonary complications (PPC), associated with increased morbidity and prolonged length of hospital stay. Preventive chest physiotherapy is routinely provided, but optimization of treatment strategies is needed to improve patient outcome and resource utilization. To develop a preoperative risk prediction scorelr to assist clinical decision-making regarding physiotherapy interventions. A prospective observational single-center study included 339 of 577 eligible patients admitted for major elective cardiothoracic or abdominal surgery. Primary outcome measure was PPC amendable to chest physiotherapy. A total of 113 patients (33.3%) developed a PPC. Logistic regression modeling identified four independent predictors of PPC presented with odds ratio (OR) and 95% confidence interval. Reduced lung function (FEV1 > 50% to <75% OR 2.4 (1.4; 4.3) and FEV1 ≤ 50% OR 4.7 (1.4;16.0)), Recent unintended weight loss OR 4.5 (1.1; 18.7), Sternotomy OR 3.5 (2.0; 6.0) and Thoraco-abdominal incision OR 4.5 (2.1; 10.1). Based on assigned point values, a score dividing patients into three risk groups was developed. The score had moderate discrimination (c-statistic 0.70). By following recommended guidelines (TRIPOD) a preoperative risk prediction score including four predictors of PPC was developed. External validation of the score is currently being investigated. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
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