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@article{1833328, author = {Neto, AS and da, Costa LGV and Hemmes, SNT and Canet, J and Hedenstierna, G and Jaber, S and Hiesmayr, M and Hollmann, MW and Mills, GH and Melo, MFV and Pearse, R and Putensen, C and Schmid, W and Severgnini, P and Wrigge, H and de, Abreu MG and Pelosi, P and Schultz, MJ and Štourač, Petr and Harazim, Hana and Smékalová, Olga and Kosinová, Martina and kolacek, tomas and Hudáček, Kamil}, article_location = {Philadelphia}, article_number = {9}, doi = {http://dx.doi.org/10.1097/EJA.0000000000000845}, language = {eng}, issn = {0265-0215}, journal = {European Journal of Anaesthesiology}, title = {The LAS VEGAS risk score for prediction of postoperative pulmonary complications An observational study}, volume = {35}, year = {2018} }
TY - JOUR ID - 1833328 AU - Neto, AS - da, Costa LGV - Hemmes, SNT - Canet, J - Hedenstierna, G - Jaber, S - Hiesmayr, M - Hollmann, MW - Mills, GH - Melo, MFV - Pearse, R - Putensen, C - Schmid, W - Severgnini, P - Wrigge, H - de, Abreu MG - Pelosi, P - Schultz, MJ - Štourač, Petr - Harazim, Hana - Smékalová, Olga - Kosinová, Martina - kolacek, tomas - Hudáček, Kamil PY - 2018 TI - The LAS VEGAS risk score for prediction of postoperative pulmonary complications An observational study JF - European Journal of Anaesthesiology VL - 35 IS - 9 SP - 691-701 EP - 691-701 PB - Lippincott Williams & Wilkins SN - 02650215 N2 - BACKGROUND Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study. SETTINGS A total of 146 hospitals across 29 countries. PATIENTS Adult patients requiring intra-operative ventilation during general anaesthesia for surgery. INTERVENTIONS The cohort was randomly divided into a development subsample to construct a predictive model, and a subsample for validation. MAIN OUTCOME MEASURES Prediction performance of developed models for PPCs. RESULTS Of the 6063 patients analysed, 10.9% developed at least one PPC. Regression modelling identified 13 independent risk factors for PPCs: six patient characteristics [higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO(2) and a history of active cancer or obstructive sleep apnoea], two procedure-related features (urgent or emergency surgery and surgery lasting >= 1 h), and five intraoperative events [use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH(2)O and use of vasopressors]. The area under the receiver operating characteristic curve of the LAS VEGAS risk score for prediction of PPCs was 0.78 [95% confidence interval (95% CI), 0.76 to 0.80] for the development subsample and 0.72 (95% CI, 0.69 to 0.76) for the validation subsample. CONCLUSION The LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for prediction of PPCs. External validation is needed before use in clinical practice. ER -
NETO, AS, Costa LGV DA, SNT HEMMES, J CANET, G HEDENSTIERNA, S JABER, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, R PEARSE, C PUTENSEN, W SCHMID, P SEVERGNINI, H WRIGGE, Abreu MG DE, P PELOSI, MJ SCHULTZ, Petr ŠTOURAČ, Hana HARAZIM, Olga SMÉKALOVÁ, Martina KOSINOVÁ, tomas KOLACEK a Kamil HUDÁČEK. The LAS VEGAS risk score for prediction of postoperative pulmonary complications An observational study. \textit{European Journal of Anaesthesiology}. Philadelphia: Lippincott Williams \&{} Wilkins, 2018, roč.~35, č.~9, s.~691-701. ISSN~0265-0215. Dostupné z: https://dx.doi.org/10.1097/EJA.0000000000000845.
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