PMID: 16618956Apr 19, 2006Paper

Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians

Annals of Internal Medicine
Gerald W SmetanaAmerican College of Physicians

Abstract

The importance of clinical risk factors for postoperative pulmonary complications and the value of preoperative testing to stratify risk are the subject of debate. To systematically review the literature on preoperative pulmonary risk stratification before noncardiothoracic surgery. MEDLINE search from 1 January 1980 through 30 June 2005 and hand search of the bibliographies of retrieved articles. English-language studies that reported the effect of patient- and procedure-related risk factors and laboratory predictors on postoperative pulmonary complication rates after noncardiothoracic surgery and that met predefined inclusion criteria. The authors used standardized abstraction instruments to extract data on study characteristics, hierarchy of research design, study quality, risk factors, and laboratory predictors. The authors determined random-effects pooled estimate odds ratios and, when appropriate, trim-and-fill estimates for patient- and procedure-related risk factors from studies that used multivariable analyses. They assigned summary strength of evidence scores for each factor. Good evidence supports patient-related risk factors for postoperative pulmonary complications, including advanced age, American Society of Anest...Continue Reading

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