Prediction of pulmonary complications following spine surgery: The ASA and ARISCAT risk indexes

Abstract

Objective: We aimed to evaluate the effectiveness of predicting postoperative pulmonary complications (PPCs) following spine surgery, comparing American Society of Anesthesiologist (ASA) and Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk scoring systems. Material and methods: We reviewed 377 patients aged≥18 years who had undergone vertebral surgery. Demographic data, comorbidities, ASA classification, body mass index, ARISCAT risk score, pulmonary complications developing with in the postoperative 1st month were assessed. Results: A total of 377 patients, 221 (58.6%) women and 156 (41.4%) men, mean age of 59±11.8 years were evaluated. Out of the 377 patients, 73 (19.4%) patients were ASA I, 235 (62.3%) patients were ASA II, 69 (18.3%) patients were ASA III, and the mean ARISCAT score was 22.51±8.38. In the postoperative period, PPC was identified in 30 (8%) patients, with atelectasis in 15 (4%), pneumothorax in 4 (1.1%), pneumonia in 4 (1.1%), respiratory failure in 4 (1.1%), bronchospasm in 2 (0.5%) patients, and pulmonary embolism in 1 (0.3%) patient. There was a statistically significant correlation between the presence of PPC and ASA score, and between the presence of PPC and the ARISCAT levels (p=0.000, p=0.000). The incidence of PPC increased with increasing ASA scores. The ARISCAT scores were higher in patients who developed PPC. The hospital stay of patients with PPCs were longer than other patients (p=0.000). Conclusion: In our study, in which ASA classification and ARISCAT risk index were compared as a means to predict PPC, both scores were found to be effective.

Keywords

• ASA
• postoperative complications
• spine
• surgery