Predicting Pulmonary Complications Following Upper and Lower Abdominal Surgery: ASA vs. ARISCAT Risk Index [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-28158 | DOI: 10.5152/TJAR.2019.28158  

Predicting Pulmonary Complications Following Upper and Lower Abdominal Surgery: ASA vs. ARISCAT Risk Index

Sibel Kara1, Elif Küpeli2, Hatice Eylül Bozkurt Yılmaz1, Hakan Yabanoğlu3
1Department of Chest Disease, Başkent University Adana Training and Research Center, Adana, Turkey
2Department of Chest Diseases, Başkent University School of Medicine, Ankara, Turkey
3Department of General Surgery, Başkent University Adana Teaching and Research Center, Adana, Turkey

Objective: Postoperative pulmonary complications (POPC) account for a substantial proportion of risk related to surgery and anaesthesia. The American Society of Anesthesiologists (ASA) classification and the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index correlate well with POPC. Here, we compared their accuracy in predicting pulmonary complications following upper and lower abdominal surgery.
Methods: We retrospectively reviewed the medical records of patients undergoing upper and lower abdominal surgery. We collected patients’ demographic data, comorbidities, preoperative pulmonary risk score, laboratory results, surgical data, respiratory tract infection history within one month before surgery, surgical urgency, ASA scores and pulmonary complications within one month after the surgery.
Results: We evaluated 241 patients [upper abdominal surgery (UAS) n=121; lower abdominal surgery (LAS) n=120; mean age 55.7±3.1 years]. In the UAS, 55.8% of the patients were male. In LAS, all patients were female. In both groups, the most common POPC was pleural effusion with compressive atelectasis (CA). Regarding risk score, in both groups, patients with high-risk developed a higher rate of pulmonary complications [UAS (50%), LAS (40%)]. In patients with low-risk scores, the rate of pulmonary complications was significantly lower than the intermediate and high-risk groups (p<0.001). A positive correlation was observed between preoperative risk score and complications (UAS r=0.34; LAS r=0.35 p<0.05). No association was observed between the ASA scores and POPC (p=0.8).
Conclusion: The ASA classification was found to be a weaker modality than ARİSCAT risk index to predict pulmonary complications after the upper and lower abdominal surgeries.

Keywords: Abdominal surgery, ARISCAT, ASA, postoperative complications

Corresponding Author: Sibel Kara, Türkiye

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