Resumen
Este estudio retrospectivo observacional analizó la eficacia de dos herramientas de puntuación para identificar complicaciones pulmonares después de la cirugía cardíaca.
Se evaluaron 508 pacientes utilizando dos herramientas diferentes: la escala de Kroenke y la escala del Grupo de Melbourne.
Los resultados mostraron que ambas herramientas son efectivas en la identificación de pacientes con complicaciones pulmonares postoperatorias.
La herramienta de Kroenke es mejor para identificar pacientes con eventos adversos pulmonares leves, mientras que la escala de Melbourne es más efectiva en la identificación de complicaciones pulmonares moderadas a graves.
Es importante que los fisioterapeutas estén familiarizados con estas herramientas para una evaluación adecuada y una intervención temprana.
Fisioterapia en la prevención de complicaciones pulmonares post-cirugía cardíaca
La fisioterapia juega un papel crucial en la detección y reducción de complicaciones pulmonares tras cirugía cardíaca. Mediante herramientas efectivas y técnicas específicas, los fisioterapeutas pueden mejorar la recuperación postoperatoria y disminuir el riesgo de complicaciones en pacientes sometidos a cirugía cardíaca.
Abstract original
Comparison of Tools for Postoperative Pulmonary Complications After Cardiac Surgery
Objectives: To review the efficacy of 2 score tools for identifying pulmonary complications after cardiac surgery.
Design: A retrospective observational study.
Setting: At the West China Hospital of Sichuan University General Hospital.
Participants: Patients who underwent elective cardiac surgery (N = 508).
Interventions: Not applicable.
Measurements and main results: A total of 508 patients who underwent elective cardiac surgery between March 2021 and December 2021 were included in this observational study. Three independent physiotherapists used 2 different sets of score tools, as described by Kroenke et al. (Kroenke Score) and Reeve et al. (Melbourne Group Scale), to evaluate clinically defined pulmonary complications according to the European Perioperative Clinical Outcome definitions (including atelectasis, pneumonia, and respiratory failure) daily after surgery at midday. The incidence of postoperative pulmonary complications (PPCs) was 51.6% (262/508) with the Kroenke Score and 21.9% (111/508) with the Melbourne Group Scale. The clinically observed incidence of atelectasis was 51.4%, pneumonia was 20.9%, and respiratory failure at 6.5%. The receiver operator characteristics curve showed that the overall validity of the Kroenke Score was better than that of the Melbourne Group Scale in atelectasis (area under the curve [AUC], 91.5% v 71.3%). The Melbourne Group Scale performed better in pneumonia (AUC, 99.4% v 80.0%) and respiratory failure (AUC, 88.5% v 75.9%) than the Kroenke Score.
Conclusion: The incidence of PPCs after cardiac surgery was highly prevalent. Both the Kroenke Score and the Melbourne Group Scale are effective in identifying patients with PPCs. Kroenke Score can identify patients with mild pulmonary adverse events, whereas the Melbourne Group Scale is more dominant in identifying moderate-to-severe pulmonary complications.
| Autores | Yuqiang Wang Zeruxin Luo Wei Huang Xiu Zhang Yingqiang Guo Pengming Yu |
| revista | J Cardiothorac Vasc Anesth |
| DOI | 10.1053/j.jvca.2023.03.031 |