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Comparison of recognition tools for postoperative pulmonary complications following thoracotomy.

Agostini, Paula and Naidu, Babu V and Cieslik, H and Rathinam, Sridhar and Bishay, Ehab and Kalkat, M S and Rajesh, P B and Steyn, R S and Singh, S (2011) Comparison of recognition tools for postoperative pulmonary complications following thoracotomy. Physiotherapy, 97 (4). pp. 278-83. ISSN 1873-1465.

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Official URL: http://www.sciencedirect.com/science/article/pii/S...

Abstract

OBJECTIVES

To evaluate the recognition of postoperative pulmonary complications (PPC) following thoracotomy and lung resection using three PPC scoring tools.

DESIGN

Prospective observational study.

SETTING

Regional thoracic centre.

PARTICIPANTS

One hundred and twenty-nine consecutive thoracotomy and lung resection patients (October 2007 and April 2008).

MAIN OUTCOME MEASURES

PPC assessment was performed on a daily basis using three sets of criteria described by Brooks-Brunn, Gosselink et al. and Reeve et al.: the Brooks-Brunn Score (BBS), Gosselink Score (GS) and Melbourne Group Scale (MGS), respectively. The results were compared with treatment for PPC and clinical outcomes including mortality, postoperative length of stay and high dependency unit length of stay.

RESULTS

PPC frequency was 13% (17/129) with the MGS, 6% (8/129) with the GS and 40% (51/129) with the BBS. The clinically observed incidence of treated (requiring antibiotic therapy or bronchoscopy) PPC was 12% (16/129).

CONCLUSION

PPC treatment following thoracotomy is common. Of the three scoring tools, the MGS outperforms the BBS and the GS in terms of PPC recognition following thoracotomy and lung resection. Patients with a PPC-positive MGS score have a worse outcome as defined by mortality, high dependency unit length of stay and postoperative length of stay. The MGS is an easy-to-use multidisciplinary scoring tool, but further work is required into its use in minimally invasive surgery and in targeting high-risk groups for therapy.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Thoracic Surgery
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Depositing User: Mrs Caroline Tranter
Date Deposited: 29 Aug 2014 08:22
Last Modified: 29 Aug 2014 08:22
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/599

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