V2 Evaluation of risk prediction models for postoperative pulmonary complications in adults undergoing major abdominal surgery: A systematic review and external validation study of the REspiratory COmplications after abdomiNal surgery (RECON) cohort. (8th April 2021)

• Record Type: Journal Article
• Authors: Kouli, Omar
• Is Part Of: BJS open. Volume 5:Supplement 1(2021)
• Publication Date: 2021-04-08
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjsopen/zrab034.001
• Languages: English
• ISSNs: 2474-9842

Abstract

Abstract: Background: Postoperative pulmonary complications (PPCs) following major abdominal surgery result in substantial morbidity and mortality, yet stratifying patients for risk-modifying interventions remains challenging. This study aimed to identify and externally validate PPC risk prediction models in an international, prospective cohort. Methods: A systematic review was conducted to identify risk prediction models for PPC following abdominal surgery. External validation was performed using data from a prospective dataset of adult patients undergoing major abdominal surgery from January to April 2019 in the UK, Ireland and Australia. The primary outcome was identification of PPC within 30-days (StEP-COMPAC criteria definition). Model discrimination and diagnostic accuracy were compared. Results: Six unique risk prediction models were eligible from 2819 records. These were validated across 11, 591 patients, with an overall PPC rate of 7.8% (n = 903). The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score provided the best discrimination (AUC: 0.709 (95% CI: 0.692-0.727), yet no risk prediction model demonstrated good discrimination (AUC >0.7). Conclusion: The risk of PPC for patients following major abdominal surgery in the pre-covid era is not well described by existing prediction tools. New prediction tools are required to account for additional variation introduced for patients affected by SARS-CoV-2 infection.