Home » 2) Pulmonary Risk » Assessing Risk of Postoperative Pulmonary Complications

Assessing Risk of Postoperative Pulmonary Complications

Guiding Question:
Can a patient be healthy but still be at high risk of postoperative pulmonary complications? Why?

 

The clinical history is the most important element of the preoperative pulmonary evaluation; more so than for cardiac risk evaluation. Patient and procedure-related risk factors are used to estimate the risk of postoperative pulmonary complications, with procedure-related risk factors imparting the greatest risk.  The physical exam helps confirm the history and determine if the patient’s underlying lung disease is optimized.  PFTs and chest xrays play a limited role in risk assessment.

 

Learning Objectives:

  • Assess pulmonary risk using validated risk calculators (R1, R2, R3)
  • Perform preoperative pulmonary testing in appropriate patients (R2, R3)

 

Review cases 1 and 2  for this section of the module.

Gupta postoperative pneumonia risk calculator

Learning Resources:
Readings:

  1. 2006 ACP Guidelines pgs 576 – 578 (stop at “Strategies To Reduce Postoperative Pulmonary Complications)
  2. Development and Validation of a Risk Calculator Predicting Postoperative Respiratory Failure
  3. Development and Validation of a Risk Calculator for Predicting Postoperative Pneumonia
  4. UpToDate chapter: Evaluation of Preoperative Pulmonary Risk

Videos: (total viewing time 21:38)

  1. Patient Related Risk Factors for Postop Pulmonary Complications (5:15)
  2. Procedure Related Risk Factors for Postop Pulmonary Complications (4:41)
  3. Prediction Rules for Postoperative Pulmonary Complications (6:36)
  4. Who needs to undergo preoperative pulmonary testing? (5:06)

Annotated PowerPoint Slides: (Note: To download the slides click “Save” at the top of the presentation. After downloading, click on “View” tab and view as “Notes Page”)

  1. Patient Related Risk Factors for Postop Pulmonary Complications (5 slides)
  2. Procedure Related Risk Factors for Postop Pulmonary Complications (7 slides)
  3. Gupta Indices for Postop Pulmonary Complications (6 slides)
  4. Who Needs Preoperative Testing Prior to Noncardiothoracic Surgery? (5 slides)