New Tool Helps Predict Surgical Patients' Pulmonary Risk
Estimates put mechanical ventilation expenditure at $1,522 per day per patient in the intensive care unit. Although the need for ventilation is not widespread — about one to three percent of patients who have non-emergency surgical procedures require ventilation afterward — the consequences are nonetheless significant, according to researchers.
"The need for artificial mechanical ventilation after operations is infrequent, but when it happens it does carry high costs," says study co-author Adam P. Johnson, MD, MPH. "Ventilator dependence is highly associated with mortality, and in and of itself is a morbidity."
The Jefferson team examined ACS NSQIP data on 7,473 patients who had elective general or vascular operations at the institution between 2006 and 2013. The scoring system assigned points for different factors, such as current smoker (1 point), age older than 60 years (2 points), and oesophagus procedures (3 points). Total risk scores ranged from 0 to 7 for study subjects. The median risk score for patients who did not need the ventilator after operations was 2, while that for patients who did need the ventilator was 3. Those with a score above 3 comprised the 20 percent of patients who experienced 70 percent of adverse events, the researchers explained.
Other risk factors associated with postoperative ventilator dependence were a diagnosis of severe chronic obstructive pulmonary disease; signs of active infection or inflammatory response; and low albumin counts, a sign of malnutrition. "Our goal was to quantify how each factor affects the risk of ventilator dependence," said Dr. Johnson. After identifying this smaller set of high risk patients, "the goal then is to optimise them before and during their hospital stay," he added.
The team says other hospitals may be able to use the scoring system to identify ventilator dependence risks in their own patient populations. "Our institution's risk score may not be generalisable, but the methodology of how we developed and then implemented the risk score may be used at other hospitals when looking at their own patients," Dr. Johnson said.
The findings were presented at the 2015 American College of Surgeons National Surgical Quality Improvement Program Conference.
Source: American College of Surgeons
Image credit: Google images
new method to avoid costly postoperative ventilation
Published on : Thu, 30 Jul 2015
Print as PDF
The HAMILTON-C1 neo is a versatile neonatal ventilator that combines invasive and noninvasive modes with the additional options of nCPAP and high flow oxygen therapy. The integrated turbine allows it to be operated independently of a compressed air supply....
Get an complete overview of your POCT setup - from one dashboard Your point-of-care-testing setup probably involves many different types of devices from various manufacturers. Radiometer's AQURE point-of-care management system can give you an overview...
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
17 critical parameters from a blood sample as small as 45 µL Not available in the US When the sample is small but your diagnostic needs are big, the ABL90 FLEX PLUS blood gas analyzer provides critical insights with a turnaround time of less than...