Prospective external validation of a predictive score for postoperative pulmonary complications.

Abstract:

BACKGROUND:No externally validated risk score for postoperative pulmonary complications (PPCs) is currently available. The authors tested the generalizability of the Assess Respiratory Risk in Surgical Patients in Catalonia risk score for PPCs in a large European cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe). METHODS:Sixty-three centers recruited 5,859 surgical patients receiving general, neuraxial, or plexus block anesthesia. The Assess Respiratory Risk in Surgical Patients in Catalonia factors (age, preoperative arterial oxygen saturation in air, acute respiratory infection during the previous month, preoperative anemia, upper abdominal or intrathoracic surgery, surgical duration, and emergency surgery) were recorded, along with PPC occurrence (respiratory infection or failure, bronchospasm, atelectasis, pleural effusion, pneumothorax, or aspiration pneumonitis). Discrimination, calibration, and diagnostic accuracy measures of the Assess Respiratory Risk in Surgical Patients in Catalonia score's performance were calculated for the Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe cohort and three subsamples: Spain, Western Europe, and Eastern Europe. RESULTS:The full Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe data set included 5,099 patients; 725 PPCs were recorded for 404 patients (7.9%). The score's discrimination was good: c-statistic (95% CI), 0.80 (0.78 to 0.82). Predicted versus observed PPC rates for low, intermediate, and high risk were 0.87 and 3.39% (score <26), 7.82 and 12.98% (≥ 26 and <45), and 38.13 and 38.01% (≥ 45), respectively; the positive likelihood ratio for a score of 45 or greater was 7.12 (5.93 to 8.56). The score performed best in the Western Europe subsample-c-statistic, 0.87 (0.83 to 0.90) and positive likelihood ratio, 11.56 (8.63 to 15.47)-and worst in the Eastern Europe subsample. The predicted (5.5%) and observed (5.7%) PPC rates were most similar in the Spain subsample. CONCLUSIONS:The Assess Respiratory Risk in Surgical Patients in Catalonia score predicts three levels of PPC risk in hospitals outside the development setting. Performance differs between geographic areas.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Mazo V,Sabaté S,Canet J,Gallart L,de Abreu MG,Belda J,Langeron O,Hoeft A,Pelosi P

doi

10.1097/ALN.0000000000000334

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

219-31

issue

2

eissn

0003-3022

issn

1528-1175

journal_volume

121

pub_type

杂志文章,多中心研究
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    abstract:BACKGROUND:Combining a hypnotic and an analgesic to produce sedation, analgesia, and surgical immobility required for clinical anesthesia is more common than administration of a volatile anesthetic alone. The aim of this study was to apply response surface methods to characterize the interactions between remifentanil a...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/00000542-200608000-00009

    authors: Manyam SC,Gupta DK,Johnson KB,White JL,Pace NL,Westenskow DR,Egan TD

    更新日期:2006-08-01 00:00:00

  • Intraoperative modulation of alveolar macrophage function during isoflurane and propofol anesthesia.

    abstract:BACKGROUND:Alveolar macrophages are a critical part of the defense against pulmonary infection. Thus the authors determined time-dependent changes in alveolar macrophage functions in patients having surgery who were anesthetized with isoflurane or propofol. METHODS:Patients anesthetized with propofol (n = 30) or isofl...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199811000-00012

    authors: Kotani N,Hashimoto H,Sessler DI,Kikuchi A,Suzuki A,Takahashi S,Muraoka M,Matsuki A

    更新日期:1998-11-01 00:00:00

  • Exercise produces sensitivity to metocurine.

    abstract::Chronic muscle disuse decreases the sensitivity of skeletal muscle to nondepolarizing relaxants, such as metocurine (MTC). In this study, the authors determined whether chronic conditioning would produce the opposite effect and increase the sensitivity of skeletal muscle to MTC. Five dogs were exercised by daily runni...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198906000-00015

    authors: Gronert GA,White DA,Shafer SL,Matteo RS

    更新日期:1989-06-01 00:00:00

  • The effect of clonidine on cerebral blood flow velocity, carbon dioxide cerebral vasoreactivity, and response to increased arterial pressure in human volunteers.

    abstract:BACKGROUND:Because patients may be taking clonidine chronically or may be receiving it as a premedication before surgery, the authors investigated its effect on cerebral hemodynamics. METHODS:In nine volunteers, middle cerebral artery mean blood flow velocity (Vm) was measured using transcranial Doppler ultrasonograph...

    journal_title:Anesthesiology

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    doi:10.1097/00000542-199709000-00015

    authors: Lee HW,Caldwell JE,Dodson B,Talke P,Howley J

    更新日期:1997-09-01 00:00:00

  • Epigastric antinociception by cervical dorsal column lesions in rats.

    abstract:BACKGROUND:Previous clinical evidence and electrophysiologic studies in the authors' laboratory have implicated the dorsal column (DC) as an important pathway for the transmission of visceral colorectal pain. This study examined, behaviorally and electrophysiologically, the role of the DC in mediating epigastric nocice...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199808000-00018

    authors: Feng Y,Cui M,Al-Chaer ED,Willis WD

    更新日期:1998-08-01 00:00:00

  • Positron emission tomography study of regional cerebral metabolism in humans during isoflurane anesthesia.

    abstract:BACKGROUND:Although the anesthetic effects of the intravenous anesthetic agent propofol have been studied in the living human brain using brain imaging technology, the nature of the anesthetic state evident in the human brain during inhalational anesthesia remains unknown. To examine this issue, the authors studied the...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199703000-00006

    authors: Alkire MT,Haier RJ,Shah NK,Anderson CT

    更新日期:1997-03-01 00:00:00

  • Fibromyalgia survey criteria are associated with increased postoperative opioid consumption in women undergoing hysterectomy.

    abstract:BACKGROUND:The current study was designed to test the hypothesis that the fibromyalgia survey criteria would be directly associated with increased opioid consumption after hysterectomy even when accounting for other factors previously described as being predictive for acute postoperative pain. METHODS:Two hundred eigh...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000637

    authors: Janda AM,As-Sanie S,Rajala B,Tsodikov A,Moser SE,Clauw DJ,Brummett CM

    更新日期:2015-05-01 00:00:00

  • Differential effects of halothane and isoflurane on contractile force and calcium transients in cardiac Purkinje fibers.

    abstract:BACKGROUND:Halothane and isoflurane have been shown to differentially effect mechanisms of contraction in working myocardial fibers. The aim of this study was to compare effects of halothane and isoflurane on contractile force (CF) and Ca2+ transients in canine cardiac Purkinje fiber preparations. METHODS:Fiber prepar...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199406000-00024

    authors: Stowe DF,Sprung J,Turner LA,Kampine JP,Bosnjak ZJ

    更新日期:1994-06-01 00:00:00

  • Comparison of 0.5% ropivacaine and 0.5% bupivacaine for epidural anesthesia in patients undergoing lower-extremity surgery.

    abstract::Ropivacaine is an amide local anesthetic structurally related to, but appearing less cardiotoxic, than bupivacaine. The authors' investigation was designed in a randomized, double-blind fashion to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower-extremity surgery. Forty-fi...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199004000-00010

    authors: Brown DL,Carpenter RL,Thompson GE

    更新日期:1990-04-01 00:00:00

  • Presynaptic and postsynaptic effects of the anesthetics sevoflurane and nitrous oxide in the human spinal cord.

    abstract:BACKGROUND:Reduced spinal excitability contributes to the suppression of movement responses to noxious stimuli during the anesthetic state. This study examines and compares presynaptic and postsynaptic effects of two anesthetics in the human spinal cord. METHODS:The authors tested two parameters during the administrat...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000282099.30437.46

    authors: Baars JH,Benzke M,von Dincklage F,Reiche J,Schlattmann P,Rehberg B

    更新日期:2007-10-01 00:00:00

  • Inhibition of superoxide production and Ca2+ mobilization in human neutrophils by halothane, enflurane, and isoflurane.

    abstract::The inhibitory effects of three inhalation anesthetics, i.e., halothane, enflurane, and isoflurane, on superoxide production and the intracellular mobilization of calcium in human neutrophils were studied. The superoxide production induced by N-formyl-methionyl-leucyl-phenylalanine (FMLP) was inhibited by the anesthet...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198601000-00002

    authors: Nakagawara M,Takeshige K,Takamatsu J,Takahashi S,Yoshitake J,Minakami S

    更新日期:1986-01-01 00:00:00

  • Xenon does not alter cardiac function or major cation currents in isolated guinea pig hearts or myocytes.

    abstract:BACKGROUND:The noble gas xenon (Xe) has been used as an inhalational anesthetic agent in clinical trials with little or no physiologic side effects. Like nitrous oxide, Xe is believed to exert minimal unwanted cardiovascular effects, and like nitrous oxide, the vapor concentration to achieve 1 minimum alveolar concentr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200002000-00035

    authors: Stowe DF,Rehmert GC,Kwok WM,Weigt HU,Georgieff M,Bosnjak ZJ

    更新日期:2000-02-01 00:00:00

  • Emulsified isoflurane enhances thermal transient receptor potential vanilloid-1 channel activation-mediated sensory/nociceptive blockade by QX-314.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000236

    authors: Zhou C,Liang P,Liu J,Zhang W,Liao D,Chen Y,Chen X,Li T

    更新日期:2014-08-01 00:00:00

  • Transcranial Doppler to Predict Neurologic Outcome after Mild to Moderate Traumatic Brain Injury.

    abstract:BACKGROUND:To assess the performance of transcranial Doppler (TCD) in predicting neurologic worsening after mild to moderate traumatic brain injury. METHODS:The authors conducted a prospective observational study across 17 sites. TCD was performed upon admission in 356 patients (Glasgow Coma Score [GCS], 9 to 15) with...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0000000000001165

    authors: Bouzat P,Almeras L,Manhes P,Sanders L,Levrat A,David JS,Cinotti R,Chabanne R,Gloaguen A,Bobbia X,Thoret S,Oujamaa L,Bosson JL,Payen JF,Asehnoune K,Pes P,Lefrant JY,Mirek S,Albasini F,Scrimgeour C,Thouret JM,Char

    更新日期:2016-08-01 00:00:00

  • Relationship between anesthetic procedure and contact of anesthesia personnel with patient body fluids.

    abstract::We recorded the frequency with which anesthesia personnel came in contact with patient body fluids in order to provide an empirical basis for the recommendation of relevant precautions. Anesthesia personnel completed a questionnaire when performing a range of standardized procedures. The rate of contact with blood was...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199010000-00006

    authors: Kristensen MS,Sloth E,Jensen TK

    更新日期:1990-10-01 00:00:00

  • Comparison of MAC and the rate of rise of alveolar concentration of sevoflurane with halothane and isoflurane in the dog.

    abstract::The anesthetic requirements for sevoflurane, isoflurane, and halothane were determined in mongrel dogs. The MACs (minimum alveolar concentration) of sevoflurane, isoflurane, and halothane were 2.36 +/- 0.46% (n = 18), 1.39 +/- 0.25% (n = 10), and 0.89 +/- 0.20% (n = 12), respectively (mean +/- SD). In agreement with s...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198803000-00020

    authors: Kazama T,Ikeda K

    更新日期:1988-03-01 00:00:00

  • High-efficiency delivery of salbutamol with a metered-dose inhaler in narrow tracheal tubes and catheters.

    abstract::We sought to determine the percent delivery by metered-dose inhaler (MDI) of a preparation of salbutamol (albuterol) to the distal end of either pediatric-size tracheal tubes or a narrow-gauge catheter. A bench model consisting of a swivel actuator; 3.0-6.0-mm ID tracheal tubes all 16 cm in length or a 19-G (standard ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199102000-00024

    authors: Taylor RH,Lerman J

    更新日期:1991-02-01 00:00:00

  • Artifact Processing Methods Influence on Intraoperative Hypotension Quantification and Outcome Effect Estimates.

    abstract:BACKGROUND:Physiologic data that is automatically collected during anesthesia is widely used for medical record keeping and clinical research. These data contain artifacts, which are not relevant in clinical care, but may influence research results. The aim of this study was to explore the effect of different methods o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003131

    authors: Pasma W,Peelen LM,van Buuren S,van Klei WA,de Graaff JC

    更新日期:2020-04-01 00:00:00

  • Effect of flumazenil on ventilatory drive during sedation with midazolam and alfentanil.

    abstract:BACKGROUND:Patients who receive a combination of a benzodiazepine and an opioid for conscious sedation are at risk for developing respiratory depression. While flumazenil effectively antagonizes the respiratory depression associated with a benzodiazepine alone, its efficacy in the presence of both a benzodiazepine and ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199610000-00005

    authors: Gross JB,Blouin RT,Zandsberg S,Conard PF,Häussler J

    更新日期:1996-10-01 00:00:00

  • Beneficial effects of short-term vasopressin infusion during severe septic shock.

    abstract:BACKGROUND:Septic shock is associated with vasopressin deficiency and a hypersensitivity to its exogenous administration. The goal of the current study was to determine whether short-term vasopressin infusion in patients experiencing severe septic shock has a vasopressor sparing effect while maintaining hemodynamic sta...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200203000-00011

    authors: Patel BM,Chittock DR,Russell JA,Walley KR

    更新日期:2002-03-01 00:00:00

  • Bupivacaine-induced cardiac arrhythmias in sheep.

    abstract::Controversy persists about the cardiac toxicity of bupivacaine if accidentally administered intravenously during regional anesthesia. Using awake, unanesthetized sheep, we evaluated the cardiac effects of low and high equivalent doses of lidocaine and bupivacaine given intravenously over 10 s. All animals convulsed wi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198401000-00004

    authors: Kotelko DM,Shnider SM,Dailey PA,Brizgys RV,Levinson G,Shapiro WA,Koike M,Rosen MA

    更新日期:1984-01-01 00:00:00

  • Anesthetic influence on arteriolar diameters and tissue oxygen tension in hemorrhaged rats.

    abstract::Arteriolar diameters and tissue oxygen tensions were measured in the cremaster muscles of 68 hemorrhaged rats which were anesthetized with either intramuscular ketamine, 125 mg/kg, plus 30 mg/kg supplements as needed, or enflurane, 2.2% inspired. Animals breathed room air, or room air plus enflurane, throughout the ex...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198209000-00006

    authors: Longnecker DE,Ross DC,Silver IA

    更新日期:1982-09-01 00:00:00

  • On-demand rather than daily-routine chest radiography prescription may change neither the number nor the impact of chest computed tomography and ultrasound studies in a multidisciplinary intensive care unit.

    abstract:BACKGROUND:Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients. METHODS:This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000296069.00566.16

    authors: Kröner A,Binnekade JM,Graat ME,Vroom MB,Stoker J,Spronk PE,Schultz MJ

    更新日期:2008-01-01 00:00:00

  • Antioxidants protect calsequestrin-1 knockout mice from halothane- and heat-induced sudden death.

    abstract:BACKGROUND:Mice lacking calsequestrin-1 (CASQ1-null), a Ca-binding protein that modulates the activity of Ca release in the skeletal muscle, exhibit lethal hypermetabolic episodes that resemble malignant hyperthermia in humans when exposed to halothane or heat stress. METHODS:Because oxidative species may play a criti...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000748

    authors: Michelucci A,Paolini C,Canato M,Wei-Lapierre L,Pietrangelo L,De Marco A,Reggiani C,Dirksen RT,Protasi F

    更新日期:2015-09-01 00:00:00

  • Lidocaine and pentylenetetrazol seizure thresholds in cats are not reduced after enflurane anesthesia.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198105000-00010

    authors: Heavner JE,Amory DW

    更新日期:1981-05-01 00:00:00

  • Cerebral extracellular glucose and lactate concentrations during and after moderate hypoxia in glucose- and saline-infused rats.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199210000-00017

    authors: Harada M,Okuda C,Sawa T,Murakami T

    更新日期:1992-10-01 00:00:00

  • The minimum alveolar concentration of isoflurane in patients undergoing bilateral tubal ligation in the postpartum period.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199506000-00007

    authors: Zhou HH,Norman P,DeLima LG,Mehta M,Bass D

    更新日期:1995-06-01 00:00:00

  • Efficacy of continuous insufflation of oxygen combined with active cardiac compression-decompression during out-of-hospital cardiorespiratory arrest.

    abstract:BACKGROUND:During experimental cardiac arrest, continuous insufflation of air or oxygen (CIO) through microcannulas inserted into the inner wall of a modified intubation tube and generating a permanent positive intrathoracic pressure, combined with external cardiac massage, has previously been shown to be as effective ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200006000-00007

    authors: Saïssy JM,Boussignac G,Cheptel E,Rouvin B,Fontaine D,Bargues L,Levecque JP,Michel A,Brochard L

    更新日期:2000-06-01 00:00:00

  • Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Interscalene block provides optimal shoulder surgery analgesia, but concerns over its associated risks have prompted the search for alternatives. Suprascapular block was recently proposed as an interscalene block alternative, but evidence of its comparative analgesic effect is conflicting. This meta-analysis...

    journal_title:Anesthesiology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/ALN.0000000000001894

    authors: Hussain N,Goldar G,Ragina N,Banfield L,Laffey JG,Abdallah FW

    更新日期:2017-12-01 00:00:00

  • Deuterated methoxyflurane anesthesia and renal function in Fischer 344 rats.

    abstract::Inorganic fluoride (F-) production and renal function were assessed in six groups of Fischer 344 rats administered either methoxyflurane (MOF) or deuterated methoxyflurane (d4-MOF). One untreated and one phenobarbital (PB)-treated group were exposed for two hours to either air, 0.5 per cent (V/v) MOF, or 0.5 per cent ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198203000-00009

    authors: Baden JM,Rice SA,Mazze RI

    更新日期:1982-03-01 00:00:00