British Journal of Anaesthesia, Vol 83, Issue 2 262-270, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
F. Chung, G. Mezei and D. Tong
We have developed mathematical models to estimate the risk of perioperative
adverse events in patients with pre-existing conditions undergoing day-case
surgery. We studied 17,638 consecutive day-case surgical patients in a
prospective study. Preoperative, intraoperative and postoperative data were
collected. Risk modelling was performed with backward stepwise multiple
logistic regression and validated on a separate subset of our patients.
Eighteen pre-existing conditions were entered into the model. We adjusted
for age, sex, and duration and type of surgery. Seven associations between
pre-existing medical conditions and perioperative adverse events were
statistically significant. Hypertension predicted the occurrence of any
intraoperative event and intraoperative cardiovascular events. Obesity
predicted intraoperative and postoperative respiratory events, and smoking
and asthma predicted postoperative respiratory events. Gastro-oesophageal
reflux predicted intubation-related events. The presented models of risk
estimation were validated internally and provided a useful tool for
accurate risk estimation.
CLINICAL INVESTIGATIONS
Pre-existing medical conditions as predictors of adverse events in day- case surgery
Department of Anaesthesia, Toronto Hospital, Western Division, University of Toronto, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8
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