Efficacy of Assessment of Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) Score Versus Local Assessment of Ventilatory Management During General Anesthesia for Surgery (LAS VEGAS) Score in Predicting Postoperative Pulmonary Complications in Abdominal Surgeries: A Comparative Study

Hira  Khurshid; Jmail  Salamat; Afaque Ali; Waseem  Ahmad Khan; Muttahhar  Asim; Sana  Zahid Toor

doi:10.51253/pafmj.v76iSUPPL-8.14219

Authors

Hira Khurshid Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Jmail Salamat Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Afaque Ali Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Waseem Ahmad Khan Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muttahhar Asim Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Sana Zahid Toor Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-8.14219

Keywords:

ARISCAT, LAS VEGAS, Postoperative Pulmonary Complications, Risk assessment, Surgery

Abstract

Objective: To determine and compare the diagnostic accuracy of ARISCAT and LAS VEGAS scores in predicting postoperative pulmonary complications (PPCs) in patients undergoing surgery and to determine independent risk factors that are related to PPCs.

Study Design: Cross-sectional validation study.

Place and Duration of Study: PEMH, Rawalpindi, Pakistan, from Jan to Jun 2025.

Methodology: Demographic and clinical data of patients and comorbidities, BMI, type of surgery, and duration of surgery were gathered. PPCs were documented after surgery. ARISCAT and LAS VEGAS scores were computed and dichotomized into low and moderate/ high-risk. Diagnostic performance, sensitivity, specificity, PPV, NPV, and accuracy were taken into consideration when assessing the diagnostic performance. Chi-square test was applied to assess the association between different variables and postoperative pulmonary complications.

Results: Out of 186 patients, 78(41.9%) patients developed PPCs. The ARISCAT score had a sensitivity of 74.4%, specificity of 47.2%, PPV of 50.4%, NPV of 71.8%, and overall accuracy of 58.6%. LAS VEGAS score was lower, with a sensitivity of 66.7%, a specificity of 41.7%, a PPV of 45.2%, a NPV of 63.4%, and an accuracy of 52.2%. On bivariate analysis, diabetes mellitus (p=0.035) and ARISCAT score (p=0.003) showed a significant association with PPCs, while other variables were not statistically significant (p>0.05).

Conclusion: The ARISCAT score is better than the LAS VEGAS score in predicting PPCs. The inclusion of ARISCAT in perioperative evaluation could help to initially record those patients who can be at high risk and implement preemptive measures.

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References

pulmonary complications after major abdominal surgery in elderly patients and their association with patient-controlled analgesia. BMC Geriatrics 2024; 24(1): 751.

https://doi.org/10.1186/s12877-024-05337-y

2. Tuna ME, Akgün M. Preoperative pulmonary evaluation to prevent postoperative pulmonary complications. Anesthesiol Perioper Sci 2023; 1(4): 34.

https://doi.org/10.1007/s44254-023-00034-2

3. Lee HJ, Lee HW. Comprehensive Strategies for Preoperative Pulmonary Risk Evaluation and Management. Tuberc Respir Dis 2024; 88(1): 90. https://doi.org/10.4046/trd.2024.0118

4. Cai BB, Wang DP. Risk factors for postoperative pulmonary complications in neonates: a retrospective cohort study. World J Pediatr Surg 2023; 6(4): e000657.

https://doi:10.1136/wjps-2023-000657

5. Lusquinhos J, Tavares M, Abelha F, Lusquinhos Sr J. Postoperative pulmonary complications and perioperative strategies: a systematic review. Cureus 2023; 15(5): 38786.

https://doi.org/10.7759/cureus.38786

6. Agrawal P. Study on postoperative pulmonary complications in patients who underwent upper abdominal surgery. Int J Acad Med Pharm 2023; 5(2): 1333-1339.

https://doi:10.47009/jamp.2023.5.2.281

7. Rosenberg J, Fuchs-Buder T. Deep Neuromuscular Blockade During General Anesthesia: Advantages, Challenges, and Future Directions. Anesth Res 2025; 2(2): 8.

https://www.mdpi.com/2813-5806/2/2/8#

8. Schwartz J, Parsey D, Mundangepfupfu T, Tsang S, Pranaat R, Wilson J, et al. Pre-operative patient optimization to prevent postoperative pulmonary complications-Insights and roles for the respiratory therapist: A narrative review. Can J Respir Ther 2020; 56: 79-85.

https://doi:10.29390/cjrt-2020-029

9. Nithiuthai J, Siriussawakul A, Junkai R, Horugsa N, Jarungjitaree S, Triyasunant N. Do ARISCAT scores help to predict the incidence of postoperative pulmonary complications in elderly patients after upper abdominal surgery? An observational study at a single university hospital. Periopr Med 2021; 10(1): 43.

https://doi.org/10.1186/s13741-021-00214-3

10. Kamaluddin S, Salahuddin A, Adil A, Musba AM, Dat MD. Comparative validity of the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score and Surgical Lung Injury Prediction (SLIP-2) in predicting the incidence of postoperative pulmonary complications in thoracic surgery. Critical Care Shock 2025; 28(5).

11. Sarma R, Bora M, Gohain M. Predictability of post-operative pulmonary complications in the subjects residing in upper Assam using the ARISCAT score. Int J LifeSci Biotechnol Pharma Res 2023; 12(4): 1160-1164.

12. Ferrando-Ortolá C, Rodríguez A, Becerra Á, Cabrera S, Guerra E, Focaccio CA, et al. Postoperative pulmonary complications in emergency abdominal surgery. A prospective international cohort study. Anaesth Critical Care Pain Med 2025; 44(5): 101560. https://doi.org/10.1016/j.accpm.2025.101560

13. Kokotovic D, Degett TH, Ekeloef S, Burcharth J. The ARISCAT score is a promising model to predict postoperative pulmonary complications after major emergency abdominal surgery: an external validation in a Danish cohort. Euro J Trauma Emerg Surg 2022; 48(5): 3863-3867.

https://doi.org/10.1007/s00068-021-01826-6

14. Neto AS, da Costa LG, Hemmes SN, Canet J, Hedenstierna G, Jaber S, et al. The LAS VEGAS risk score for prediction of postoperative pulmonary complications: an observational study. European Journal of Anaesthesiology| EJA. 2020; 35(9): 691-701.

https://doi.org/10.1097/EJA.0000000000000845

15. Siddiqui KM, Farooqui MH, Yousuf MS, Ali MA. ARISCAT and LAS VEGAS risk scores for predicting postoperative pulmonary complications after cardiac surgery: a cohort study. Ann Med Surg 2024; 86(7): 3873-3879.

https://doi.org/10.1097/MS9.0000000000002191

16. Garg S, Govindaraj V, Dwivedi DP, Raja K, Theerthar EP. Postoperative pulmonary complications in patients undergoing upper abdominal surgery: risk factors and predictive models. Monaldi Arch Chest Dis 2025; 95(1).

https://doi.org/10.4081/monaldi.2024.2915

17. Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, et al. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4(7): e520-e531. https://doi.org/10.1016/S2589-7500(22)00069-3

18. Tilak KM, Litake MM, Shingada KV. Study of risk, incidence, and mortality associated with postoperative pulmonary complications using the Assess Respiratory Risk in Surgical Patients in Catalonia score. Int Surg J 2019; 6: 3215-3222.

http://dx.doi.org/10.18203/2349-2902.isj20194054