Рossibility Prediction of Critical Incident during Elective Surgery in Abdominal Surgery


K.A. Tsygankov, A.V. Shchegolev, D.A. Averianov, S.V. Bokatyuk

FGBVOU VPO «Military-Medical Academy n.a. C.M. Kirov» MO RF, St. Petersburg

For citation: Tsygankov KA, Shchegolev AV, Averianov DA, Bokatyuk SV. Critical Incident Prediction Рossibility in Elective Abdominal Surgery. Intensive Care Herald. 2016;2:80–84. 

Тhe aim of the study. This article describes a method of prediction of critical incidents. Materials and methods. In the study 52 patients were included, mean age was 61 (55; 68) years. The physical status classification ASA II 39 patients (75 %), ASA III — 13 patients (25 %). In the preoperative period, patients performed a six-minute test and a questionnaire filled daily activities of Duke. The next day performed cardiorespiratory exercise testing. To perform this test using «Ultima CPX» company Medical Graphics (USA) system. On stage, the anesthesia monitoring of critical incidents and use of statistical methods is determined which of the indexes has the highest predictive value. Results. Using logistic regression revealed the possibility of prediction of critical incidents using the anaerobic threshold and the six-minute test. In constructing the ROC-curve is obtained that the low sensitivity and specificity of the six-minute test does not allow the use of this method for predicting the development of critical incidents, in contrast, the anaerobic threshold testified to the high probability of critical incidents. The area of the curve was 0.991. The significance of the area (p < 0.05) showed the usefulness of anaerobic threshold to determine the likelihood of critical incidents. From the curve coordinate table we found that the threshold sensitivity of 100 % and specificity of 95 % is the value of 10.85 ml/kg/min. Given the data rate of the critical analyzed incidents resulting revealed that patients with less anaerobic threshold 10.85 ml/kg/min developed 36 (85.7 %) of the critical stages of anesthesia incidents, and in patients with more anaerobic threshold 10.85 ml/kg/min, only 6 (14.2 %). Conclusions. These results confirm the possibility of prediction of critical incidents in the preoperative period with the help of the anaerobic threshold.

Keywords: preoperative examination, functional status, cardiorespiratory exercise test, anaerobic threshold, critical incidents

Received: 18.04.2016


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