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
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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 · 12:00 AM
Last Checked: November 7, 2020
Next Review: November 7, 2025