ARISCAT Score for Postoperative Pulmonary Complications

Predicts risk of pulmonary complications after surgery to help guide clinician decision making.

Refer to the text below the calculator for more information on predicting postoperative pulmonary complications and the original study that the score is based on.

The ARISCAT Score can help guide clinician’s decisions to operate under general, neuraxial or regional anesthesia or to employ other therapies based on the patient’s predicted risk of developing pulmonary complications after surgery.

Postoperative pulmonary complications defined as: respiratory failure, respiratory infection, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis).

ARISCAT Score Interpretation

ARISCAT Score Risk Group Risk of in-hospital postoperative pulmonary complications
<26 Low 1.6%
26 - 44 Intermediate 13.3%
>44 High 42.1%
1

Age

2

Preoperative SpO2

3

Respiratory infection in past month

Either upper or lower (URI, bronchitis, pneumonia), with fever and antibiotic treatment
4

Preoperative anemia (Hb ≤10 g/dL)

5

Surgical incision

6

Duration of surgery

7

Emergency procedure

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ARISCAT Score Explained

The ARISCAT score can help clinicians predict risk or postoperative pulmonary complications (PPCs) in patients meant to undergo surgery under general, neuraxial, or regional anesthesia.

The score consists in 7 perioperative variables, with each answer awarded a number of points which then contributes to the composite score:

ARISCAT Score Variable Answer Choices Pts
Patient Age ≤50 0
51 - 80 3
>80 16
Preoperative SpO2 ≥96% 0
91-95% 8
≤90% 24
Respiratory infection in past month: Either upper or lower (URI, bronchitis, pneumonia), with fever and antibiotic treatment No 0
Yes 17
Preoperative anemia (Hb ≤10 g/dL) No 0
Yes 11
Surgical incision Peripheral 0
Upper abdominal 15
Intrathoracic 24
Duration of surgery <2 hrs 0
2-3 hrs 16
>3 hrs 23
Emergency procedure No 0
Yes 8

PPCs are defined as: respiratory failure, respiratory infection, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis).

As observed from the table below, the higher the score, the greater the risk of PPCs:

ARISCAT Score Risk Group Risk of in-hospital postoperative pulmonary complications
<26 Low 1.6%
26 - 44 Intermediate 13.3%
>44 High 42.1%

Employing the ARISCAT score may come with the following benefits:

  • Guides decision making to reduce risk of PPCs occurring;
  • Encourages preventative strategies;
  • Increases use of non-surgical procedures where appropriate;
  • Shortens the time for surgery;
  • Promotes use of tissue-sparing approaches.

The original study by Canet et al. set out to develop a predictive index for a broad surgical population. A cohort of 2,464 patients from 59 hospitals were randomly selected and two subsamples were created, one for the development of the score (via logistic regression model) and one for validation of the predictive index.

Out of the total cohort, 252 events were observed in 5% of patients (123) and 30-day mortality was higher in patients with a PPC than in those without a PPC.

Regression modelling identified the seven independent risk factors that are currently in use, with the following ROC characteristics:

  • 90% (95% CI, 85-94%) for the development subsample;
  • 88% (95% CI, 84-93%) for the validation subsample.
 

References

Original reference

Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010; 113(6):1338-1350.

Validation

Mazo V, Sabaté S, Canet J, et al. Prospective external validation of a predictive score for postoperative pulmonary complications. Anesthesiology. 2014; 121(2):219-231.

Other references

Gupta S, Fernandes RJ, Rao JS, Dhanpal R. Perioperative risk factors for pulmonary complications after non-cardiac surgery. J Anaesthesiol Clin Pharmacol. 2020; 36(1):88-93.

Specialty: Surgery

Year Of Study: 2010

Abbreviation: ARISCAT

Article By: Denise Nedea

Published On: October 19, 2020 · 12:00 AM

Last Checked: October 19, 2020

Next Review: October 19, 2025