# Validation of the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Score for Predicting Postoperative Pulmonary Complications After Laparotomy in an Indian Population in the Present Era: A Retrospective Study

## TL;DR

This study tested a European-developed risk score for predicting postoperative lung problems in Indian patients but found it ineffective.

## Contribution

Validated the ARISCAT score's limited utility in predicting PPCs in an Indian surgical population.

## Key findings

- The ARISCAT score failed to distinguish between low- and high-risk patients for PPCs in this population.
- The area under the ROC curve was 0.567, indicating poor predictive performance.
- Logistic regression analysis showed no significant relationship between risk factors and PPC occurrence.

## Abstract

Introduction

Postoperative pulmonary complications (PPCs) lead to increased ICU admissions, duration of hospital stay, and mortality. Optimizing the modifiable risk factors before surgery helps reduce PPCs. A risk score named Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) was designed for the prediction of PPCs in the surgical group of patients by a study conducted in Europe. The study aims to test the generalizability of the ARISCAT risk score for PPCs in our population.

Methods

Data on preoperative risk factors and the occurrence of postoperative pulmonary complications, as defined in the ARISCAT study, were collected from the medical records of 539 patients undergoing surgery under general anesthesia during February 2017 to February 2020, and 501 were included in the final analysis. Categorical data was compared using the Chi-square test. Regression analysis was performed to assess the relationship between individual risk factors and the occurrence of PPC. The goodness of fit was tested using the Hosmer-Lemeshow test.

Results

Incidence of PPC did not show a statistically significant difference for age (p=0.855), preoperative respiratory infection (p=0.859), site of incision (p=0.523), duration of surgery (p=0.191), nature of surgery (emergency/elective) (p=0.922), preoperative anemia (p=0.388), albumin (p=0.393), and length of hospital stay (p=0.393). The overall incidence of PPC was 25 (4.9%). The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.567 with a 95% CI of 0.5-0.7. The p-value for goodness of fit was 0.0001. The logistic regression analysis was insignificant.

Conclusion

The ARISCAT score was unable to discriminate between low- and high-risk groups for PPCs in our study population and may have limited utility in similar institutional settings.