A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications.
Abstract
There is a need for robust, clearly defined, patient-relevant outcome measures for
use in randomised trials in perioperative medicine. Our objective was to establish
standard outcome measures for postoperative pulmonary complications research.A systematic
literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean
Journal Database. Definitions were extracted from included manuscripts. We then conducted
a three-stage Delphi consensus process to select the optimal outcome measures in terms
of methodological quality and overall suitability for perioperative trials.From 2358
records, the full texts of 81 manuscripts were retrieved, of which 45 met the inclusion
criteria. We identified three main categories of outcome measure specific to perioperative
pulmonary outcomes: (i) composite outcome measures of multiple pulmonary outcomes
(27 definitions); (ii) pneumonia (12 definitions); and (iii) respiratory failure (six
definitions). These were rated by the group according to suitability for routine use.
The majority of definitions were given a low score, and many were imprecise, difficult
to apply consistently, or both, in large patient populations. A small number of highly
rated definitions were identified as appropriate for widespread use. The group then
recommended four outcome measures for future use, including one new definition.A large
number of postoperative pulmonary outcome measures have been used, but most are poorly
defined. Our four recommended outcome measures include a new definition of postoperative
pulmonary complications, incorporating an assessment of severity. These definitions
will meet the needs of most clinical effectiveness trials of treatments to improve
postoperative pulmonary outcomes.
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Journal articleSubject
StEP-COMPAC GroupPermalink
https://hdl.handle.net/10161/17267Published Version (Please cite this version)
10.1016/j.bja.2018.02.007Publication Info
Abbott, TEF; Fowler, AJ; Pelosi, P; Gama de Abreu, M; Møller, AM; Canet, J; ... StEP-COMPAC
Group (2018). A systematic review and consensus definitions for standardised end-points in perioperative
medicine: pulmonary complications. British journal of anaesthesia, 120(5). pp. 1066-1079. 10.1016/j.bja.2018.02.007. Retrieved from https://hdl.handle.net/10161/17267.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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