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% |
Send Us Your Feedback
Steps on how to print your input & results:
1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.
2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.
Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.
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