Comparison of Tools for Postoperative Pulmonary Complication Following Cardiac surgery

Abstract Objectives: To review the efficacy of two scoring tools for identifying pulmonary complications after cardiac surgery.Method: A total of 244 patients underwent elective cardiac surgery between March 2021 and December 2021 were included in this observational study. Three independent physiotherapists use two different sets of PPC scoring criteria, described by Kroenke et al (Kroenke Score) and Reeve et al (Melbourne Group Scale [MGS]) to evaluate PPC status daily following surgery at midday. We then retrospective analysis the occurrence of PPC was performed 14 days postoperatively according to European Perioperative Clinical Outcome (EPCO) definitions (included atelectasis, pleural effusion, pneumonia and respiratory failure).Result: PPC frequency was 46.31% (113/244) with the Kroenke Score, 25.82% (63/244) with the Melbourne Group Scale. The clinically observed incidence of PPC (atelectasis 41.80%, pleural effusion 24.59%, pneumonia 40.57%, respiratory failure 20.08%) was 53.69% (131/244). The ROC curve shows that the overall validity of the Kroenke score is better than that of the Melbourne Group Scale (AUC, 0.94 vs. 0.88, p=0.01). The Kroenke Score performed better in open-heart surgery cohort than the Melbourne Group Scale (AUC, 0.97 vs. 0.87, p<0.01), while in interventional procedures cohort show similar (AUC, 0.90 vs. 0.86, p=0.32).Conclusion: The incidence of pulmonary complications following cardiac surgery was highly prevalent. Both the Kroenke Score and the MGS score are effective in identifying patients with postoperative pulmonary complications. The two scoring tools performed comparably in the interventional procedure population. Compared to MGS, the Kroenke Score performed better in the open-heart surgery population.Clinical Trial Registration: Chinese Clinical Trials Registry, identifier ChiCTR2100054869 (http://www.chictr.org.cn/).