Concordance between ARISCAT risk score and cardiopulmonary exercise test values in risk prediction of postoperative pulmonary complications of major abdominal surgeries in a tertiary cancer hospital: A cross‐sectional study

Abstract

Background and AimsPulmonary complications are common after surgery. They include vascular thrombosis, pneumonia, respiratory failure (RF), and pain‐related atelectasis. There are a number of models to predict the risk of postoperative respiratory events other than thrombosis. The aim of this study was to explore the correlation of assess respiratory risk in surgical patients in Catalonia (ARISCAT) scoring and cardiopulmonary exercise test (CPET) values in prediction of postoperative pulmonary complications (PPCs).MethodsCancer patients referred to a tertiary hospital for elective major abdominal surgeries were studied. Patients were evaluated by ARISCAT score and then CPET was performed to determine the risk of surgery based on maximal oxygen consumption (VO2) value. Patients were followed for RF occurrence up to 72 h after surgery. Finally, the concordance of ARISCAT score and CPET values was evaluated in risk prediction of PPCs.ResultsThe results showed that parameters VO2, ARISCAT score, and anaerobic threshold could predict postoperative RF. Of these parameters, ARISCAT showed the highest sensitivity (100%) and the highest specificity (90.5%) compared with other parameters (Youden's J statistic = 0.905). However, VO2 value showed the highest validity. The percentage of agreement between different subgroups (low, medium, and high) of both criteria (VO2 and ARISCAT) was equal to 81.45% (p < 0.001) and the ϰ coefficient of the given weight was equal to 0.54 (p < 0.001), indicating a good agreement between these two criteria.ConclusionARISCAT scoring showed high sensitivity and specificity to PPCs in cancer patients and good correlation with CPET value for prediction of PPCs. Therefore, it is a reliable and robust risk prediction tool in major abdominal surgeries on cancer patients.

Prehabilitation in Adults Undergoing Cancer Surgery: A Comprehensive Review on Rationale, Methodology, and Measures of Effectiveness

“…In adults undergoing major abdominal cancer surgeries, Rezaian et al found that VO 2 max was significantly lower (11.9 vs. 16.8 mL/kg/min, p < 0.0001) in patients who developed postoperative respiratory failure. Alone, CRF had a low to moderate correlation with the ARISCAT pulmonary risk score [50]. In a recent meta-analysis, Steffens et al found that a higher VO 2 max was strongly associated with improved outcomes in adults undergoing cancer surgery [51].…”