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Submitted: 22 April 2019 Modified: 16 July 2019
HERDIN Record #: 100731-1904221144530

Accuracy of risk calculator predicting postoperative respiratory failure and prolonged mechanical ventilation after a cardiothoracic surgery in the Philippine Heart Center.

Gladys Judynil B. Daba,
Ma. Encarnita Blanco-Limpin,
Aileen G. Banzon

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BACKGROUND: Postoperative Respiratory Failure (PRF) is among the most common postoperative pulmonary complications.2 It's usually defined as failure to wean from mechanical ventilation within 48 hours of surgery or in some studies reaching to 7 days or when there is unplanned intubation 30 days postoperatively after an extubation.3,8


METHODOLOGY: This is a retrospective cross-sectional study at the Philippine Heart Center of 70 adult patients that underwent cardiothoracic surgery. Demographics and review of  5 preoperative risk factors namely ASA class, dependent functional status, emergency procedure, preoperative sepsis, and type of surgery were entered into a risk calculator and the returned percentage value was then recorded. Course in the ward was reviewed if patient had prolonged mechanical ventilation (PMV) or if patient had unplanned reintubation within 30days postoperatively, recorded as postoperative respiratory failure(PRF).


RESULTS: There were 8(11.43%) patients who had PRF and 23(32.86%) patients who had PMV. Using the cut off value of 6.44% from the calculated risk score for predicting combined outcome, sensitivity was noted to be high at 96.6% with specificity of 87.8%, with a high negative predictive valve of 97.3% and accuracy of 91.4% at 95% confidence interval.


CONCLUSION: The risk calculator predicting postoperative respiratory failure and prolonged mechanical ventilation using the cut off of 6.44% has sensitivity of 96.6%, specificity of 87.8%, and an accuracy of 91.4%, thus, can be use to risk stratify patients who will undergo cardiothoracic surgery.

Publication Type
Research Report
Date
January 1-December 31, 2018
LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library PHC.R.050.18 Fulltext Print Format