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 (%) = e^x / (1 + e^x)

x = −2.8977 + sum of the values of the selected variables (can be found in the text below).

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.

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 (%) = e^x / (1 + e^x)

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
Smoking within last year	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