The effectiveness of ARISCAT Risk Index, other scoring systems, and parameters in predicting pulmonary complications after thoracic surgery

Gülay Ülger, Hilal Sazak, Ramazan Baldemir, Musa Zengin, Oya Kaybal, Funda İncekara, Ali Alagöz, Gülay Ülger, Hilal Sazak, Ramazan Baldemir, Musa Zengin, Oya Kaybal, Funda İncekara, Ali Alagöz

Abstract

The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index, which is frequently used in nonthoracic surgery, may not be sufficient to predict postoperative pulmonary complications (PPCs). We aimed to evaluate the effectiveness of the ARISCAT risk index, ASA, preoperative albumin level, neutrophil/lymphocyte ratio (NLR), and other parameters in predicting PPCs after thoracic surgery. Patients undergoing elective thoracic surgery with 1-lung ventilation (OLV) were prospectively analyzed. Demographic data, ARISCAT score, ASA, Nutritional Risk Score-2002, NLR, white blood cell counts, albumin, hemoglobin levels, intraoperative complications, postoperative average visual analogue scale (VAS) score for pain at the 24th-hour, the length of stay in the postoperative intensive care unit, chest tube removal time, postoperative complications, and discharge time were recorded. Patients were assessed for morbidity and mortality on the 90th-day. 120 patients' data were analyzed. PPCs developed in 26 patients. The development of PPCs was statistically significant in patients with high ARISCAT scores (P = .002), high ARISCAT grades (P = .009), and ASA III (P = .002). The albumin level was statistically significantly lower in patients who had mortality within 3 months (P = .007). When scoring systems and laboratory parameters were evaluated together, patients with high ARISCAT grade, Albumin < 35g/L, and ASA III had significantly higher development of PPCs (P = .004). ARISCAT risk index and ASA were found to be significant in predicting PPCs after thoracic surgery. They were also valuable when evaluated in combination with preoperative albumin levels. Additionally; age, male gender, duration of surgery, and duration of OLV were also found to be associated with PPCs.

Trial registration: ClinicalTrials.gov NCT04995939.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

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Flow chart.

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