Sofian K. Marsawidjaya1; Ujainah ZN2; Aries Perdana3; Murdani A4
1Departemen Ilmu Penyakit Dalam FKUI/RSCM
2Divisi Respirologi dan Penyakit Kritis, Departemen Ilmu Penyakit Dalam, FKUI/RSCM 3Departemen Anestesiologi FKUI/RSCM
4 Departemen Ilmu Penyakit Dalam, FKUI/RSCM

ABSTRACT
Background: Postoperative pulmonary complication had important effect in increasing morbidity, mortality as well as length of stay. Several factors contributing to those such as patient’s health status, type of operation and type anaesthesia used. There were risk score developed by Arozullah that can be used to predict the possibility of respiratory failure and postoperative pneumonia. Due to the differences of the characteristic population, the study needed internal validation to discover the performance of the Arozullah score.
Objectives: To assess the performance of calibration and discrimination of Arozullah’s model risk score in predicting complications of respiratory failure and pneumonia postoperative in patients undergoing non-cardiac surgery in Cipto Mangunkusumo General Hospital (RSCM)
Methods: A cohort retrospective study was conducted in patients undergoing non-cardiac surgery in RSCM from January to December 2015. Considered variables were type of surgery, age, emergency surgery, history of Chronic Obstructive Pulmonary Disease (COPD), serum albumin, ureum, functional status, weight loss, history of smoking, alcohol use, blood transfusions pre surgery, general anaesthesia, history of cerebrovascular disease , acute impaired sensorium, chronic steroid use. Outcomes assessed were complications of respiratory failure and pneumonia in 30 days post-operative. Performance calibration were assessed with Hosmer-Lemeshow test and performance discrimination were assessed with area under the curve (AUC).
Result: There were 403 subjects met the inclusion criteria with 74 of subjects had pulmonary complications (18.4 %). Ther are 52 subjects had respiratory failure, 34 subjects had pneumonia post operative, and 12 subjects had both complication. Hosmer-Lemeshow test on the complications of respiratory failure showed p =0.333 and the AUC value is 0.911. While pneumonia complications showed p =0.617 and AUC value is 0.789.
Conclusion: Arozullah score perioperative had good performance in predicting respiratory failure and pneumonia 30-days postoperative in RSCM.
Keywords: respiratory failure, pneumonia, non-cardiac surgery, validation, risk index score perioperative Arozullah