OBJECTIVE: The purpose of this study was to derive and validate a risk score for pneumonia (PNA) after cardiac surgery. METHODS: Adults undergoing cardiac surgery between 2005 and 2012 were identified in a single-institution database. The primary outcome was postoperative PNA. Patients were randomly assigned to training and validation sets in a 3:1 ratio. A multivariable model was constructed incorporating univariate pre- and intraoperative predictors of PNA in the training set. Points were assigned to significant risk factors in the multivariable model based on their associated regression coefficients. RESULTS: A total of 6222 patients were included. The overall rate of postoperative PNA was 4.5% (n = 282). A 33-point score incorporating 6 risk factors (age, chronic lung disease, peripheral vascular disease, cardiopulmonary bypass time, intraoperative red blood cell transfusion, and pre- or intraoperative intra-aortic balloon pump) was generated. The model used to generate the score in the training set was robust in predicting PNA (c = 0.72, P < .001). Predicted rates of PNA increased exponentially with increasing risk score, ranging from 1.2% (score = 0) to 59% (score = 33). There was significant correlation between predicted rates of PNA based on the training cohort and actual rates of pneumonia in the validation cohort in weighted regression analysis (r = 0.74, P < .001). The composite score outperformed the STS prolonged ventilation model in predicting PNA in the validation cohort (c-index 0.76 vs 0.71, respectively). CONCLUSIONS: This 33-point risk score is strongly predictive of postoperative PNA after cardiac surgery. The composite score has utility in tailoring perioperative management and in targeting diagnostic and preventative interventions.
OBJECTIVE: The purpose of this study was to derive and validate a risk score for pneumonia (PNA) after cardiac surgery. METHODS: Adults undergoing cardiac surgery between 2005 and 2012 were identified in a single-institution database. The primary outcome was postoperative PNA. Patients were randomly assigned to training and validation sets in a 3:1 ratio. A multivariable model was constructed incorporating univariate pre- and intraoperative predictors of PNA in the training set. Points were assigned to significant risk factors in the multivariable model based on their associated regression coefficients. RESULTS: A total of 6222 patients were included. The overall rate of postoperative PNA was 4.5% (n = 282). A 33-point score incorporating 6 risk factors (age, chronic lung disease, peripheral vascular disease, cardiopulmonary bypass time, intraoperative red blood cell transfusion, and pre- or intraoperative intra-aortic balloon pump) was generated. The model used to generate the score in the training set was robust in predicting PNA (c = 0.72, P < .001). Predicted rates of PNA increased exponentially with increasing risk score, ranging from 1.2% (score = 0) to 59% (score = 33). There was significant correlation between predicted rates of PNA based on the training cohort and actual rates of pneumonia in the validation cohort in weighted regression analysis (r = 0.74, P < .001). The composite score outperformed the STS prolonged ventilation model in predicting PNA in the validation cohort (c-index 0.76 vs 0.71, respectively). CONCLUSIONS: This 33-point risk score is strongly predictive of postoperative PNA after cardiac surgery. The composite score has utility in tailoring perioperative management and in targeting diagnostic and preventative interventions.
Authors: Dae H Kim; Krista F Huybrechts; Elisabetta Patorno; Edward R Marcantonio; Yoonyoung Park; Raisa Levin; Abdurrahman Abdurrob; Brian T Bateman Journal: J Am Geriatr Soc Date: 2017-02-10 Impact factor: 5.562
Authors: Wei Chen; Kai Zhong; Yan Guan; Hai Tao Zhang; He Zhang; Tuo Pan; Jun Pan; Dong Jin Wang Journal: BMC Cardiovasc Disord Date: 2022-07-07 Impact factor: 2.174
Authors: Morad Chughtai; Chukwuweike U Gwam; Nequesha Mohamed; Anton Khlopas; Jared M Newman; Rafay Khan; Ali Nadhim; Shervin Shaffiy; Michael A Mont Journal: J Clin Med Res Date: 2017-04-26