Journal of Association of Pulmonologist of Tamil Nadu (Jan 2021)
Utility of ariscat (Assess respiratory risk in surgical patients in catalonia) score in predicting postoperative pulmonary complications in patients undergoing elective/emergency surgery in a tertiary care Hospital in India
Abstract
Introduction: Postoperative pulmonary complications (PPCs) account for a substantial proportion of risk related to surgery and anesthesia and are a major cause of postoperative morbidity, mortality and longer hospital stays. Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score is a risk prediction model developed for predicting PPCs. Objectives: To calculate the Sensitivity, Specificity of ARISCAT score in predicting postoperative pulmonary complications in patients undergoing Elective/Emergency surgery in a tertiary care hospital in India and to find out the incidence of postoperative pulmonary complications in various surgeries. Materials and Methods: Study Site: Apollo Main Hospital, Greams Road, Chennai. Study Design: Prospective Observational Study. Study Period: September 2018 to March 2019. Sample Size: Three hundred and thirty cases (330). Methodology: Patients undergoing non-Obstetric Elective or Emergency surgical procedure under general, neuraxial or plexus block anaesthesia were recruited through simple random sampling technique. After taking informed written consent, demographic details and clinical history were collected. Risk for post-operative pulmonary complications was assessed based on ARISCAT score. These patients were followed in the post-operative period till discharge to look for the following postoperative pulmonary complications -1. Respiratory failure 2. Pulmonary infection 3. Pleural effusion 4. Atelectasis 5. Pneumothorax 6. Bronchospasm 7. Aspiration pneumonitis. Results: The incidence of postoperative pulmonary complications in this study was 9.4%.The incidence of postoperative pulmonary complications in peripheral surgeries, upper abdominal and intrathoracic surgeries was 2.9 %, 14.1 % and 55.6 % respectively. The Sensitivity, Specificity, PPV and NPV of ARISCAT score were 83.9 %, 80.3 %, 30.6 % and 98 % respectively. Conclusion: ARISCAT score can be used as a routine screening tool for predicting the risk of developing PPCs.
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