Comparison of recognition tools for postoperative pulmonary complications following thoracotomy
Agostini, P., Naidu, Babu V., Cieslik, H., Rathinam, S., Bishay, E., Kalkat, M. S., Rajesh, Pala Babu, Steyn, R. S. and Singh, S.. (2011) Comparison of recognition tools for postoperative pulmonary complications following thoracotomy. Physiotherapy, Vol.97 (No.4). pp. 278-283. ISSN 0031-9406
WRAP_Naidu_recognition_tools.pdf - Accepted Version - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Official URL: http://dx.doi.org/10.1016/j.physio.2010.11.007
Objectives To evaluate the recognition of postoperative pulmonary complications (PPC) following thoracotomy and lung resection using three PPC scoring tools.
Design Prospective observational study.
Setting Regional thoracic centre.
Participants One hundred and twenty-nine consecutive thoracotomy and lung resection patients (October 2007 and April 2008).
Main outcome measures PPC assessment was performed on a daily basis using three sets of criteria described by Brooks-Brunn, Gosselink et al. and Reeve et al.: the Brooks-Brunn Score (BBS), Gosselink Score (GS) and Melbourne Group Scale (MGS), respectively. The results were compared with treatment for PPC and clinical outcomes including mortality, postoperative length of stay and high dependency unit length of stay.
Results PPC frequency was 13% (17/129) with the MGS, 6% (8/129) with the GS and 40% (51/129) with the BBS. The clinically observed incidence of treated (requiring antibiotic therapy or bronchoscopy) PPC was 12% (16/129).
Conclusion PPC treatment following thoracotomy is common. Of the three scoring tools, the MGS outperforms the BBS and the GS in terms of PPC recognition following thoracotomy and lung resection. Patients with a PPC-positive MGS score have a worse outcome as defined by mortality, high dependency unit length of stay and postoperative length of stay. The MGS is an easy-to-use multidisciplinary scoring tool, but further work is required into its use in minimally invasive surgery and in targeting high-risk groups for therapy.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RD Surgery|
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Lungs -- Surgery -- Complications, Postoperative care, Lungs -- Diseases|
|Journal or Publication Title:||Physiotherapy|
|Publisher:||Elsevier Science Ltd.|
|Official Date:||December 2011|
|Page Range:||pp. 278-283|
|Access rights to Published version:||Restricted or Subscription Access|
 Garcia – Miguel FJ, Serrano- Aguilar PG, Lopez-Bastida J. Preoperative assessment. The Lancet 2003; 362:1749-1759.
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