Postoperative pulmonary complications (PPCs) are important part of the risk of surgery and prolong the hospital stay by an average of one to two weeks. It is defined as an abnormality that produces identifiable disease or dysfunction which is clinically significant and adversely affects the clinical course. Preoperative risk scores such as Shapiro risk index and Cardiopulmonary risk index (CPRI) are useful for risk assessment, where we can identify preoperatively patients who are at risk for developing PPCs.
In this study we compared the two indexes in predicting PPCs among patients who underwent elective cardiac surgery at Philippine Heart Center from January to December 2008by performing a cohort study of prospectively gathered data of 76 patients who underwent elective cardiac surgery up to the time of discharge in a one-year period.
The risk for the development of PPCs were analyzed by getting the composite outcome (n = 54). Analysis showed that smoking is the only patient-related risk factor that significantly contributed to the development of PPCs (P value = 0.027).Occurrence of PPCs based on Shapiro Risk Score and Shapiro Risk Classification showed non-correlation (P value of 0.058 and 0.71 respectively). In contrast, occurrence of PPCs based on CPRI score showed significant correlation (P value= 0.000). The ability of the two indexes to predict the timing of extubation analyzed using the spearman correlation coefficients showed significant correlation with CPRI score (P value = 0.000; Rho = 0.514). However, Shapiro risk score and classification showed non-correlation (P value = 0.571; Rho = 0.066 and P value = 0.424; Rho = 0.093 respectively).
This study showed that CPRI score is useful in predicting PPCs and timing of extubation after cardiac surgery. In contrast, Shapiro risk index does not predict its outcome. It is also noted that smoking is the only potential patient-related risk factor that may predict PPCs after cardiac surgery.
Cardiopulmonary risk index(CPRI) can be used in preoperative pulmonary evaluation of patients who will undergo cardiac surgery at Philippine Heart Center.
Erma Garcia-Lazaro, No Financial Disclosure Information; No Product/Research Disclosure Information