1. Development of a prediction model for postoperative pneumonia: A multicentre prospective observational study
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Russotto, Vincenzo, Sabate, Sergi, Canet, Jaume, Langeron, Olivier, de Abreu, Marcelo Gama, Gallart, Lluis, Javier Belda, F., Pelosi, Paolo, Hoeft, Andreas, Mazo, Valentin, Leva, Brigitte, Burimi, Jonela, Halefi, Toma, Hoxha, Aleksander, Pilika, Kliti, Selmani, Imelda, Daout, Ve'ronique, Gauthier, Caroline, Kahn, David, Momeni, Mona, Watremez, Christine, Straus, Slavenka, Djonovic-manovic, Dejana, Juros-Zovko, Marina, Komen-Usljebrka, Helga, Orlic, Vlasta, Stuck, Ivana, Balakova, Lenka, Kosinova, Martina, Krikava, Ivo, Stoudek, Roman, Stourac, Petr, Zadrazilova, Katarina, Janvekar, Sanober, Karjagin, Juri, Roivassepp, Kadri, Sormus, Alar, Cuvillon, Philippe, Ibanez-Esteve, Cristina, Raux, Mathieu, Nicolas-Robin, Armelle, Winter, Andre, Brunier, Malte, Engelhard, Kristin, Feldmann, Rita Laufenberg, Lindemann, Raphaele, Mauff, Susanne, Sebastiani, Anne, Zamperoni, Camila, Kessler, Florian, Wittmann, Maria, Bluth, Thomas, Guldner, Andreas, Kiss, Thomas, Braz, Kristina, Ruszkai, Csilla, Micaglio, Massimo, Ori, Carlo, Parotto, Matteo, Persona, Paolo, Giuseppe, Coletta, Carnesecchi, Paolo, Lazzeroni, Denise, Lorenzi, Irene, Castellani, Gianluca, Sances, Daniele, Spano, Gianluca, Tredici, Stefano, Vezzoli, Dario, Brunetti, Iole, Di Noto, Anna, Gratarola, Angelo, Molin, Alexandre, Montagnani, Luca, Pellerano, Giulia, Fusari, Maurizio, Camici, Laura, Guzzetti, Luca, Marangoni, Fabio, Severgnini, Paolo, Di Mauro, Piero, Rapido, Francesca, Tommasino, Concezione, Nemme, Ieva, Nemme, Janis, Blieka, Justinas, Borodiciene, Jurgita, Budryte, Brigita, Karbonskiene, Aurika, Kiudulaite, Inga, Milieskaite, Egle, Rasimaviciute, Renata, Sireviciene, Ugne, Stasaityte, Ramune, Usas, Edgaras, Zarskiene, Giedre, Kontrimaviciute, Egle, Sipylaite, Jurate, Tomkute, Gabija, Bardea, Petra, Klop, Marco, Koch, Marc, Bozilow, Dominika, Goch, Robert, Bonifacio, Joao, Marques, Sofia, dos Santos Ralha, Tania Teresa, Alves, Daniel, Carvalho, Ines, Da Cruz Parente, Josefina Suzana, Tome, Sara, Carmona, Cristina, Costa, Miranda, Lina, Maria, Sierra, Sofia, Balcan, Alina, Cindea, Iulia, Gherghina, Viorel Ionel, Grasa, Catalin, Copotoiu, Ruxandra, Copotoiu, Sanda-Maria, Kovacs, Judit, Szederjesi, Janos, Theil, Arthur, Filipescu, Daniela, Grytsan, Alexey, Kapkan, Tatiana, Rostovtsev, Sergey, Yushkova, Anastasia, Calderon, Ricardo, Cacho, Elena, Marginet, Carolina, Monedero, Pablo, Jose Yepes, Maria, Esparza Minana, Jose Miguel, Granell Gil, Manuel, Rico Portoles, Gabriel, Lisi, Alberto, Perez, Gisela, Poch, Nuria, Arganaraz Quinteros, Mauricio Roberto, Font Bosch, Carme, Torrellardona Llobera, Jordi, Sierra, Pilar, Matute, Mercedes, Alcon Dominguez, Amalia, Jose Arguis, Maria, Belda, Isabel, Carrero, Enrique, Moreno, Jacobo, Rovira, Irene, Ubre, Marta, Castillo, Roberto, Herrero, Silvia, Ballester Lujan, Maria Teresa, Carbonell, Jose, Gencheva, Geri, Gutierrez, Andrea, Llorens, Julio, Machado, Sofia, Llobell, Francisca, Paz Martin, Daniel, Javier Garcia-Miguel, Francisco, Perez Garcia, Anibal, Company, Roque, Ahamdanech Idrissi, Aixa, del Fresno Canaveras, Josefina, Navarro Martinez, Jose Alejandro, Paya Martinez, Estefania, Sanchez Garcia, Ester, Vera Bella, Jorge, India Aldana, Inmaculada, Manuel Campos, J., Pelaez Vaamonde, Xavier, Torra, Montserrat, Arroyo, Raquel, Carlos Cabrera, Juan, Carazo Cordobes, Jesus, Rojo, Amelia, Javier Santiveri, Francisco, Gonzalez, Miriam, Jimenez, Anabel, Jimenez, Yolanda, Marti, Agnes, Moret, Enrique, Rodriguez Nunez, Monica, Velasco, Joaquin, Calderon, Adriana, Gonzalez, Matide, Gonzalez, Olga, Hermira Anchuelo, Ana, Lopez, Eloisa, Sanchez, Esther, Aznarez Zango, Blanca, Garcia Corral, Francisco Jose, Mata Mena, Esperanza, Planas Roca, Antonio, Ayala Soto, Raquel Fernandez Rocio, Quintana, Borja, Rabanal Llevot, Jose Manuel, Williams Camus, Monica Mercedes, Palacios Blanco, Alba, Largo Ruiz, Angela, Rico Feijoo, Jesus, Castellano Garijo, Elvira, Belmonte Cuenca, Julio, Bonet Binimelis, Marcos Jose, Grigorov, Ivaylo, Lluis Aguilar, Josep, De Nadal Clanchet, Miriam, Guerrero Vinas, Encarnacion, Manrique Muniz, Susana, Martin Mora, Victor, Munar Bauza, Francisca, Nunez Aguado, Sonia, Olive Vidal, Montserrat, Panos Gozalo, Maria Luisa, Sanchez Marin, Marcos, Suescun Lopez, Maria Carmen, Maino, Paolo, Yevstratov, Yevhen Eugene, Kucukgoncu, Semra, Senturk, Nuzhet Mert, Ulke, Zerrin Sungur, Russotto, V, Sabate, S, and Canet, J
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Male ,medicine.medical_specialty ,Prognosi ,MEDLINE ,Hospital mortality ,Models, Biological ,Risk Assessment ,03 medical and health sciences ,Postoperative complications ,0302 clinical medicine ,Postoperative Complications ,030202 anesthesiology ,Odds Ratio ,Medicine ,Humans ,Anesthesia ,PULMONARY COMPLICATIONS ,HYDROXYETHYL STARCH ,HEMORRHAGIC-SHOCK ,RISK ,RESUSCITATION ,VALIDATION ,INFECTION ,SCORE ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Aged ,business.industry ,030208 emergency & critical care medicine ,Odds ratio ,Pneumonia ,Postoperative pneumonia ,Surgical procedures ,Middle Aged ,Prognosis ,respiratory tract diseases ,Europe ,Prospective Studie ,Anesthesiology and Pain Medicine ,Multicenter study ,Surgical Procedures, Operative ,Emergency medicine ,Observational study ,Female ,Postoperative Complication ,business ,Respiratory insufficiency ,Human - Abstract
BACKGROUNDPostoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems.OBJECTIVETo identify independent variables associated with the occurrence of postoperative pneumonia.DESIGNA prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database).SETTINGSixty-three hospitals in Europe.PATIENTSPatients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period.MAIN OUTCOME MEASUREThe primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 °C; leucocyte count more than 12 000 μl-1.RESULTSPostoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO2 values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572).CONCLUSIONWe identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia.TRIAL REGISTRATIONNCT 01346709 (ClinicalTrials.gov).
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- 2018