Performance of the ARISCAT Score for predicting postoperative pulmonary complications in major abdominal surgery in elderly patients

Introduction: The ARISCAT score is one of the most widely used tools to predict the probability of postoperative pulmonary complications (PPC). Objective: To determine the performance of the ARISCAT score for predicting PPC in elderly patients undergoing abdominal procedures. Methods: Retrospective cohort study including patients over 70 years of age undergoing abdominal surgery. Logistic regression was performed to determine the association between clinical and operative characteristics and the occurrence of PPC. Results: A total of 381 patients were included, with a PPC frequency of 37.5% (n=143). Mortality was 10.8% (n=41). The median ARISCAT score was 42 points (IQR 26-57), with 50.6% (n=161) classified as high risk. The most frequent PPC was respiratory failure with 56.6% (n=81). According to the adjusted logistic regression, ASA classification II and III (OR 2.49; 95% CI 1.25-4.90; p=0.009), weight loss (OR 4.16; 95% CI 1.56-11.09; p=0.004), altered sensorium (OR 5.27; 95% CI 2.46-11.32; p<0.001), diabetes mellitus (OR 2.73; 95% CI 1.33-5.55; p=0.006), atrial fibrillation (OR 5.38; 95% CI 1.27-22.76; p=0.022), and high-risk ARISCAT classification (OR 9.19; 95% CI 2.85-22.63; p<0.001) were significantly associated with the presence of PPC. In the high-risk category, the observed sensitivity was 77.1% (95% CI 68.94-83.94), and a specificity of 67.9% (95% CI 60.71-74.54). The area under the curve (AUC) for the ARISCAT score was calculated at 0.7867 (95% CI 0.737-0.834). Conclusions: The ARISCAT score is a useful tool for predicting the frequency of PPC in elderly patients.