Preoperative predictive factors for intensive care unit admission after pulmonary resection

Detalhes bibliográficos
Autor(a) principal: Pinheiro,Liana
Data de Publicação: 2015
Outros Autores: Santoro,Ilka Lopes, Perfeito,João Aléssio Juliano, Izbicki,Meyer, Ramos,Roberta Pulcheri, Faresin,Sonia Maria
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Pneumologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132015000100031
Resumo: Objective: To determine whether the use of a set of preoperative variables can predict the need for postoperative ICU admission. Methods: This was a prospective observational cohort study of 120 patients undergoing elective pulmonary resection between July of 2009 and April of 2012. Prediction of ICU admission was based on the presence of one or more of the following preoperative characteristics: predicted pneumonectomy; severe/very severe COPD; severe restrictive lung disease; FEV1 or DLCO predicted to be < 40% postoperatively; SpO2 on room air at rest < 90%; need for cardiac monitoring as a precautionary measure; or American Society of Anesthesiologists physical status ≥ 3. The gold standard for mandatory admission to the ICU was based on the presence of one or more of the following postoperative characteristics: maintenance of mechanical ventilation or reintubation; acute respiratory failure or need for noninvasive ventilation; hemodynamic instability or shock; intraoperative or immediate postoperative complications (clinical or surgical); or a recommendation by the anesthesiologist or surgeon to continue treatment in the ICU. Results: Among the 120 patients evaluated, 24 (20.0%) were predicted to require ICU admission, and ICU admission was considered mandatory in 16 (66.6%) of those 24. In contrast, among the 96 patients for whom ICU admission was not predicted, it was required in 14 (14.5%). The use of the criteria for predicting ICU admission showed good accuracy (81.6%), sensitivity of 53.3%, specificity of 91%, positive predictive value of 66.6%, and negative predictive value of 85.4%. Conclusions: The use of preoperative criteria for predicting the need for ICU admission after elective pulmonary resection is feasible and can reduce the number of patients staying in the ICU only for monitoring.
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spelling Preoperative predictive factors for intensive care unit admission after pulmonary resectionThoracic surgeryRisk factorsIntensive care units Objective: To determine whether the use of a set of preoperative variables can predict the need for postoperative ICU admission. Methods: This was a prospective observational cohort study of 120 patients undergoing elective pulmonary resection between July of 2009 and April of 2012. Prediction of ICU admission was based on the presence of one or more of the following preoperative characteristics: predicted pneumonectomy; severe/very severe COPD; severe restrictive lung disease; FEV1 or DLCO predicted to be < 40% postoperatively; SpO2 on room air at rest < 90%; need for cardiac monitoring as a precautionary measure; or American Society of Anesthesiologists physical status ≥ 3. The gold standard for mandatory admission to the ICU was based on the presence of one or more of the following postoperative characteristics: maintenance of mechanical ventilation or reintubation; acute respiratory failure or need for noninvasive ventilation; hemodynamic instability or shock; intraoperative or immediate postoperative complications (clinical or surgical); or a recommendation by the anesthesiologist or surgeon to continue treatment in the ICU. Results: Among the 120 patients evaluated, 24 (20.0%) were predicted to require ICU admission, and ICU admission was considered mandatory in 16 (66.6%) of those 24. In contrast, among the 96 patients for whom ICU admission was not predicted, it was required in 14 (14.5%). The use of the criteria for predicting ICU admission showed good accuracy (81.6%), sensitivity of 53.3%, specificity of 91%, positive predictive value of 66.6%, and negative predictive value of 85.4%. Conclusions: The use of preoperative criteria for predicting the need for ICU admission after elective pulmonary resection is feasible and can reduce the number of patients staying in the ICU only for monitoring.Sociedade Brasileira de Pneumologia e Tisiologia2015-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132015000100031Jornal Brasileiro de Pneumologia v.41 n.1 2015reponame:Jornal Brasileiro de Pneumologia (Online)instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)instacron:SBPT10.1590/s1806-37132015000100005info:eu-repo/semantics/openAccessPinheiro,LianaSantoro,Ilka LopesPerfeito,João Aléssio JulianoIzbicki,MeyerRamos,Roberta PulcheriFaresin,Sonia Mariaeng2020-05-08T00:00:00Zoai:scielo:S1806-37132015000100031Revistahttp://www.jornaldepneumologia.com.br/default.aspONGhttps://old.scielo.br/oai/scielo-oai.php||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br1806-37561806-3713opendoar:2020-05-08T00:00Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)false
dc.title.none.fl_str_mv Preoperative predictive factors for intensive care unit admission after pulmonary resection
title Preoperative predictive factors for intensive care unit admission after pulmonary resection
spellingShingle Preoperative predictive factors for intensive care unit admission after pulmonary resection
Pinheiro,Liana
Thoracic surgery
Risk factors
Intensive care units
title_short Preoperative predictive factors for intensive care unit admission after pulmonary resection
title_full Preoperative predictive factors for intensive care unit admission after pulmonary resection
title_fullStr Preoperative predictive factors for intensive care unit admission after pulmonary resection
title_full_unstemmed Preoperative predictive factors for intensive care unit admission after pulmonary resection
title_sort Preoperative predictive factors for intensive care unit admission after pulmonary resection
author Pinheiro,Liana
author_facet Pinheiro,Liana
Santoro,Ilka Lopes
Perfeito,João Aléssio Juliano
Izbicki,Meyer
Ramos,Roberta Pulcheri
Faresin,Sonia Maria
author_role author
author2 Santoro,Ilka Lopes
Perfeito,João Aléssio Juliano
Izbicki,Meyer
Ramos,Roberta Pulcheri
Faresin,Sonia Maria
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Pinheiro,Liana
Santoro,Ilka Lopes
Perfeito,João Aléssio Juliano
Izbicki,Meyer
Ramos,Roberta Pulcheri
Faresin,Sonia Maria
dc.subject.por.fl_str_mv Thoracic surgery
Risk factors
Intensive care units
topic Thoracic surgery
Risk factors
Intensive care units
description Objective: To determine whether the use of a set of preoperative variables can predict the need for postoperative ICU admission. Methods: This was a prospective observational cohort study of 120 patients undergoing elective pulmonary resection between July of 2009 and April of 2012. Prediction of ICU admission was based on the presence of one or more of the following preoperative characteristics: predicted pneumonectomy; severe/very severe COPD; severe restrictive lung disease; FEV1 or DLCO predicted to be < 40% postoperatively; SpO2 on room air at rest < 90%; need for cardiac monitoring as a precautionary measure; or American Society of Anesthesiologists physical status ≥ 3. The gold standard for mandatory admission to the ICU was based on the presence of one or more of the following postoperative characteristics: maintenance of mechanical ventilation or reintubation; acute respiratory failure or need for noninvasive ventilation; hemodynamic instability or shock; intraoperative or immediate postoperative complications (clinical or surgical); or a recommendation by the anesthesiologist or surgeon to continue treatment in the ICU. Results: Among the 120 patients evaluated, 24 (20.0%) were predicted to require ICU admission, and ICU admission was considered mandatory in 16 (66.6%) of those 24. In contrast, among the 96 patients for whom ICU admission was not predicted, it was required in 14 (14.5%). The use of the criteria for predicting ICU admission showed good accuracy (81.6%), sensitivity of 53.3%, specificity of 91%, positive predictive value of 66.6%, and negative predictive value of 85.4%. Conclusions: The use of preoperative criteria for predicting the need for ICU admission after elective pulmonary resection is feasible and can reduce the number of patients staying in the ICU only for monitoring.
publishDate 2015
dc.date.none.fl_str_mv 2015-02-01
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
dc.source.none.fl_str_mv Jornal Brasileiro de Pneumologia v.41 n.1 2015
reponame:Jornal Brasileiro de Pneumologia (Online)
instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)
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reponame_str Jornal Brasileiro de Pneumologia (Online)
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