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New Risk Calculator for Postoperative Respiratory Failure (CHEST)

By Matthew Hoffman, MD
Published Online: Friday, January 27, 2012

Himani Gupta, Prateek Gupta, and Lee Morrow of Creighton have done us all a favor by mining a national database (the National Surgical Quality Improvement Program) to create and validate a risk calculator for perioperative pulmonary complications, which they unveil in the November CHEST.

Pulmonologists are consulted every day to weigh in on the risk of perioperative complications in patients planned for surgery who have obstructive sleep apnea, chronic obstructive pulmonary disease, asthma, or interstitial lung disease. We do our best, usually coming up with phrases of dubious value like “While this patient’s [insert disease here] places him at elevated risk for complications including postoperative respiratory failure and pneumonia, the benefits of surgery appear to outweigh the possible risks at this time.”

Hey, it’s not our fault. We haven’t had the large data sets needed to create a useful predictive model like the revised cardiac risk index for cardiac complications after surgery, which would permit rational risk stratification and decision-making algorithms like the one in Circulation.

>>Click here to read the rest of this blog post at PulmCCM.org

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