Gupta Postoperative Pneumonia Risk
Helps screen patients at increased risk of postoperative pneumonia based on available clinical data.
Refer to the text below the calculator for more information about the model and the original development and validation study.
This risk screening tool can help identify patients at increased risk of postoperative pneumonia, which is a common complication of surgery, one associated with marked morbidity and mortality.
Seven preoperative predictors of postoperative pneumonia were identified via multivariate logistic regression analysis in the study by Gupta et al.
Postoperative Pneumonia Risk (%) = ex / (1 + ex)
x = −2.8977 + sum of the values of the selected variables (can be found in the text below).
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Gupta Postoperative Pneumonia Risk Screening
This risk screening tool can help identify patients at increased risk of postoperative pneumonia, which is a common complication of surgery, one associated with marked morbidity and mortality.
Postoperative pneumonia is defined as either:
- hospital-acquired pneumonia (developing 48 - 72 h after admission);
- ventilator-associated pneumonia (developing 48 - 72 h after endotracheal intubation).
The study by Gupta et al. is based on a multicenter data set from the American College of Surgeons' National Surgical Quality Improvement Program, which was analysed via univariate and multivariate logistic regression.
The 2007 part of the dataset was used as training set (211,410) whilst the 2008 part of the dataset was used as validation set (257,385).
1.8% of patients from the dataset experienced postoperative pneumonia and a significantly higher 30-day mortality.
Seven preoperative predictors of postoperative pneumonia were identified via multivariate logistic regression analysis and resulted in the below instructions on how to calculate the risk:
Postoperative Pneumonia Risk (%) = ex / (1 + ex)
Where x = −2.8977 + sum of the values of the selected variables that can be found in the table below:
Gupta Score Item | Answer Choices | Value |
Patient Age | n/a | Age x 0.0144 |
COPD causing functional disability or hospitalization, or FEV1 <75% | No | -0.4553 |
Yes | 0 | |
Functional status | Independent | 0 |
Partially dependent | 0.7653 | |
Totally dependent | 0.9400 | |
ASA Physical Status | 1: Normal healthy patient | -3.0225 |
2: Mild systemic disease | -1.6057 | |
3: Severe systemic disease | -0.4915 | |
4: Severe systemic disease that is a constant threat to life | 0.0123 | |
5: Moribund, not expected to survive without surgery | 0 | |
Sepsis | None | -0.7641 |
Preoperative systemic inflammatory response syndrome | 0 | |
Preoperative sepsis | -0.0842 | |
Preoperative septic shock | 0.1048 | |
Smoking within last year | No | -0.4306 |
Yes | 0 | |
Type of procedure | Anorectal | -0.8470 |
Aortic | 0.7178 | |
Bariatric | -0.6282 | |
Brain | 0.6841 | |
Breast | -2.3318 | |
Cardiac | 0.1382 | |
ENT (except thyroid/parathyroid) | -0.3665 | |
Foregut or hepatopancreatobiliary | 1.0660 | |
Gallbladder, appendix, adrenals, or spleen | -0.3951 | |
Hernia (ventral, inguinal, femoral) | 0 | |
Intestinal | 0.6169 | |
Neck (thyroid/parathyroid) | -0.0872 | |
Obstetric/gynecologic | -0.4101 | |
Orthopedic and non-vascular extremity | -0.5415 | |
Other abdominal | 0.4021 | |
Peripheral vascular | -0.4519 | |
Skin | -0.5075 | |
Spine | -0.5672 | |
Non-esophageal thoracic | 0.8901 | |
Vein | -1.4760 | |
Urology | 0.1076 |
The tool was further validated with similar model performance (C statistic: 0.860 and 0.855, respectively) and excellent predictive performance.
References
Original reference
Gupta H, Gupta PK, Schuller D, Fang X, Miller WJ, Modrykamien A, Wichman TO, Morrow LE. Development and validation of a risk calculator for predicting postoperative pneumonia. Mayo Clin Proc. 2013; 88(11):1241-9.
Other reference
Chughtai M, Gwam CU, Mohamed N, Khlopas A, Newman JM, Khan R, Nadhim A, Shaffiy S, Mont MA. The Epidemiology and Risk Factors for Postoperative Pneumonia. J Clin Med Res. 2017; 9(6):466-475.
Specialty: Surgery
Year Of Study: 2013
Article By: Denise Nedea
Published On: November 1, 2020 · 12:00 AM
Last Checked: November 1, 2020
Next Review: November 1, 2025