Perioperative medicine & outcomes
Preoperative Spirometry in Patients With Known or Suspected Chronic Obstructive Pulmonary Disease Undergoing Major Surgery: The Prospective Observational PREDICT Study
Authors' conclusion
Neither a structured COPD-specific assessment nor preoperative PFTs added incremental diagnostic value to the standard clinical preassessment in patients with known or suspected COPD.
Study context
- Population
- Patients with known or suspected chronic obstructive pulmonary disease (COPD) (GOLD key indicators) scheduled for major surgerycompleted follow-up
- Participants
- 320 patients
- Exposure
- Standard model vs COPD assessment model vs PFT model for predicting PPCs
- Outcome
- Prediction of PPCs (cross-validated AUC)
Methodological detailssingle-centre, multivariable risk prediction models, LASSO cross-validation, 31,714 assessed for eligibility; 1271 received pulmonary function tests (PFTs); 240 with confirmed COPD (78 GOLD I, 125 GOLD II, 28 GOLD III, 9 GOLD IV) and 80 without COPD
- Single-centre
- Multivariable risk prediction models
- LASSO cross-validation
- 31,714 assessed for eligibility; 1271 received PFTs; 240 with confirmed COPD (78 GOLD I, 125 GOLD II, 28 GOLD III, 9 GOLD IV) and 80 without COPD
Main finding
As reported in the abstract
Diagnostic performance for PPC
| Group | cvAUC | Bc-b 95% CI |
|---|---|---|
| Standard model | 0.723 | 0.663-0.775 |
| COPD assessment model | 0.724 | 0.662-0.777 |
| PFT model | 0.729 | 0.668-0.782 |
cvAUC
Standard model0.723
COPD assessment model0.724
PFT model0.729
Bc-b 95% CI
Standard model0.663-0.775
COPD assessment model0.662-0.777
PFT model0.668-0.782
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted OR | P value |
|---|---|---|
| %FEV1 PRED as predictor of PPCs in the PFT model (only PFT parameter selected by LASSO) | 0.98 | P = 0.030 |
- %FEV1 PRED as predictor of PPCs in the PFT model (only PFT parameter selected by LASSO): independent predictor; CI bounds as printed in the abstract are malformed
Previously known COPD as predictor of PPCs
- Independent predictor in the standard and COPD assessment models
PPC risk by GOLD grade (secondary aim)
- Risk of PPCs significantly increased with GOLD grades
- P < 0.001
Newly diagnosed COPD
- Proportion of confirmed COPD newly diagnosed
- 53.8%
- Newly diagnosed COPD not at increased PPC risk
- P = 0.338
Original publication
Preoperative Spirometry in Patients With Known or Suspected Chronic Obstructive Pulmonary Disease Undergoing Major Surgery: The Prospective Observational PREDICT Study. Anesth Analg. Published 1 November 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →