Gupta Postoperative Respiratory Failure Risk

Helps predict risk of mechanical ventilation for longer than 48 hours or risk of reintubation within 30 days from surgery.

Refer to the text below the calculator for more information about the original study and the variables used in the model.


This risk screening tool can help identify patients at increased risk of postoperative respiratory failure, defined as risk of mechanical ventilation for >48 hrs after surgery, or unplanned intubation ≤30 days of surgery.

The study by Gupta et al. identified five preoperative predictors that are employed in the model to determine a percentage risk of respiratory failure.


Postoperative respiratory failure risk* (%) = ex / (1 + ex)

x = −1.7397 + sum of the values of the selected variables

*Risk of mechanical ventilation for >48 hrs after surgery, or unplanned intubation ≤30 days of surgery


Functional status
ASA Physical Status
Sepsis
Emergency case
Type of procedure
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Gupta Postoperative Respiratory Failure Risk Explained

This risk screening tool identifies patients at increased risk of postoperative respiratory failure, defined as risk of mechanical ventilation for >48 hrs after surgery, or unplanned intubation ≤30 days of surgery.

The study by Gupta et al. identified five preoperative predictors that are employed in the model to determine a percentage risk of respiratory failure.

The study was based on multicenter data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). The 2007 dataset (211,410) served for development whilst the 2008 dataset (257,385) was used to validate the model. 3.1% of the patients in the training set developed postoperative respiratory failure.

The model performance was very similar between the training and the validation data sets (c-statistic, 0.894 and 0.897, respectively).

Postoperative respiratory failure risk* (%) = ex / (1 + ex)

x = −1.7397 + sum of the values of the selected variables

*Risk of mechanical ventilation for >48 hrs after surgery, or unplanned intubation ≤30 days of surgery

Gupta Score Item Answer Choices Value
Functional status Independent 0
Partially dependent 0.7678
Totally dependent 1.4046
ASA Physical Status 1: Normal healthy patient -3.5265
2: Mild systemic disease -2.0008
3: Severe systemic disease -0.6201
4: Severe systemic disease that is a constant threat to life 0.2441
5: Moribund, not expected to survive without surgery 0
Sepsis None -0.7840
Preoperative systemic inflammatory response syndrome 0
Preoperative sepsis 0.2752
Preoperative septic shock 0.9035
Emergency case No -0.5739
Yes 0
Type of procedure Anorectal -1.3530
Aortic 1.0781
Bariatric -1.0112
Brain 0.7336
Breast -2.6462
Cardiac 0.2744
ENT (except thyroid/parathyroid) 0.1060
Foregut or hepatopancreatobiliary 0.9694
Gallbladder, appendix, adrenals, or spleen -0.5668
Hernia (ventral, inguinal, femoral) 0
Intestinal 0.5737
Neck (thyroid/parathyroid) -0.5271
Obstetric/gynecologic -1.2431
Orthopedic and non-vascular extremity -0.8577
Other abdominal 0.2416
Peripheral vascular -0.2389
Skin -0.3206
Spine -0.5220
Non-esophageal thoracic 0.6715
Vein -2.0080
Urology 0.3093
 

Original Reference

Gupta H, Gupta PK, Fang X, Miller WJ, Cemaj S, Forse RA, Morrow LE. Development and validation of a risk calculator predicting postoperative respiratory failure. Chest. 2011; 140(5):1207-1215.


Specialty: Surgery

Objective: Risk Screening

Year Of Study: 2011

Article By: Denise Nedea

Published On: November 7, 2020

Last Checked: November 7, 2020

Next Review: November 7, 2025