6 research outputs found
Compare the Quality of Life in Type 2 Diabetic Patients with Healthy Individuals (Application of WHOQOL-BREF)
- Author
- Publication venue
- 'Kowsar Medical Institute'
- Publication date
- Field of study
Personal, Familial, and Social Factors Contributing to Addiction Relapse, Ahvaz, Iran
- Author
- Publication venue
- 'Kowsar Medical Institute'
- Publication date
- Field of study
Modeling of ammonia removal from wastewater using air stripping/modified clinoptilolite: reusability, optimization, isotherm, kinetic, and equilibrium studies
- Author
- A Azogh
- A Bonmatı́
- A Dashti
- A De la Torre-Velasco
- A Elgarahy
- A Farkas
- A Khalil
- A Malovanyy
- A Mazeikiene
- A Mirahsani
- A Sharma
- A Sukor
- AH Englert
- B Aghel
- B Atallah
- C Cabrera
- C Li
- C Liu
- D Karadag
- D Karadag
- E Passaglia
- EP Favvas
- F Al-Sheikh
- F Özogul
- G Montégut
- GM Haggerty
- H Faghihian
- H Guo
- H Mirzaei
- H Zhang
- J Guo
- K Elwakeel
- K Jahangiri
- K Pilchowski
- KZ Elwakeel
- KZ Elwakeel
- KZ Elwakeel
- KZ Elwakeel
- KZ Elwakeel
- M Khazaei
- M Shaban
- M Sprynskyy
- M Zieliński
- M-H Yuan
- MR Adam
- N Widiastuti
- NM Hilal
- O Korkuna
- Q Du
- Q Yin
- R Malekian
- S Ashrafizadeh
- S Ghadiri
- S Wang
- S Yin
- SB Wang
- SJ Montalvo
- SK Alpat
- SK Ghadiri
- SM Ahari
- X Quan
- Y Qin
- Y Wang
- Y-b Dong
- YP Zhao
- Z Gholami
- Z-Y Ji
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Antimicrobial Efficacy of Mixtures of Nanosilver and Zinc Oxide Eugenol against Enterococcus faecalis
- Author
- Anumula L Kumar S, Kumar VS, Sekhar C, Krishna M, Pathapati RM, Venkata Sarath P, Vadaganadam Y, Manne RK, Mudlapudi S.
- Chaloupka K Malam Y, Seifalian AM.
- Cohen S.
- Gomes BP Pedroso JA, Jacinto RC, Vianna ME, Ferraz CC, Zaia AA, de Souza-Filho FJ.
- Haghgoo R Ataie M, Rezvani MB, Labibzadeh A.
- Hernández-Sierra JF Ruiz F, Pena DC, Martínez-Gutiérrez F, Martínez AE, Guillén Ade J, Tapia-Pérez H, Castañón GM.
- Kaiwar A Nadig G, Hegde J, Lekha S.
- Kim JS Kuk E, Yu KN, Kim JH, Park SJ, Lee HJ, Kim SH, Park YK, Park YH, Hwang CY.
- Kishen A Shi Z, Shrestha A, Neoh KG.
- Lins RX de Oliveira Andrade A, Hirata Junior R, Wilson MJ, Lewis MA, Williams DW, Fidel RA.
- Magalhães RAP Santos LB, Lopes LG, de Araújo Estrela CR, Estrela C, Torres EM, Bakuzis AF, Cardoso PC, Carrião MS.
- Niakan M Abbasi F, Hamedi R, Aliasghar E, Najafi F, Fatemi M.
- Poggio C Lombardini M, Colombo M, Dagna A, Saino E, Arciola CR, Visai L.
- Queiroz AM Nelson-Filho P, Silva LA, Assed S, Silva RA, Ito IY.
- Rai M Yadav A, Gade A.
- Sadeghi R Owlia P, Rezvani MB, Taleghani F, Sharif F.
- Samiei M Aghazadeh M, Lotfi M, Shakoei S, Aghazadeh Z, Vahid Pakdel SM.
- Shantiaee Y Dianat O, Janani A, Kolahi Ahari G.
- Tchaou WS Turng BF, Minah GE, Coll JA.
- Publication venue
- 'Jaypee Brothers Medical Publishing'
- Publication date
- Field of study
Chemical Characterization of Hydrolyzed Protein Meal Obtained from Trout (Oncorynchus My kiss) By-products Silage
- Author
- Adler-Nissen J.
- Adler-Nissen J.
- Anderson JS Higgs DA, Beames RM, Rowshandeli M.
- Beaulieu L Thibodeau J, Bonnet C, Bryl P, Carbonneau M-E.
- Castillo M Rojas A, WinChing R.
- Chalamaiah M Dinesh Kumar B, Hemalatha R, Jyothirmayi T.
- Chalamaiah M Rao GN, Rao DG, Jyothirmayi T.
- Cheng X Tang X, Wang Q, Mao XY.
- Choi YJ Hur S, Choi BD, Konno K, Park JW.
- Di Gioia L Guilbert S.
- Diniz FM Martin AM.
- Domingos AK Saad EB, Vechiatto WWD, Wilhelm HM, Ramos LP.
- Dumas A de Lange CFM, France J, Bureau DP
- Ferraz DAL Borghesi R, Oetterer M.
- Foh MBK Amadou I, Kamara MT, Foh BM, Xia W.
- Garces Y Perea C, Valencia NF, Hoyos JL, Gomez JA.
- Gbogouri GA Linder M, Fanni J, Parmentier M.
- Gildberg A.
- Goosen NJ Wet LF, Gorgens JF.
- Guerard F Guimas L, Binet A.
- Gutierrez O Savon L, Toledo J, Llanes J.
- Kageyama T.
- Klomklao S Kishimura H, Benjakul S.
- Kristinsson HG Rasco BA.
- Lanes J Borquez A, Alcaino J, Toledo J.
- Liang Y Hultin HO.
- Llanes J Toledo J, Fernandez I, Lazo J.
- Luckstadts C.
- Malicki A Zawadzki W, Bruzewicz S, Graczyk S, Czerski A.
- Maqsood S Benjakul S.
- Mazorra MA Pacheco R, Ram�rez JC, Garcia G, Lugo ME.
- Munoz A Bucheli J, Bonilla R, Hoyos JL.
- Nakayama T Hayase F, Kato H.
- Nguyen HTM Sylla KSB, Randriamahatody Z, Donnay- Moreno C, Moreau J, Tran LT.
- Oliveira IS de Lourenco L de FH, Sousa CL, Peixoto Joele MRS, Ribeiro S da C do A.
- Oterhals A Samuelsen TA.
- Ovissipour M Rasco B, Shiroodi SG, Modanlow M, Gholami S, Nemati M.
- Pantoja J Sanchez S, Hoyos J.
- Prabha J Narikimelli A, Sajini MI, Vincent S.
- Raghavan S Kristinsson HG.
- Raghunath MR Gopakumar K.
- Rai AK Swapna HC, Bhaskar N, Halami PM, Sachindra NM.
- Ramasubburayan R Iyapparaj P, Subhashini K, Chandran M, Palavesam A, Immanuel G.
- Robert M Zatylny-Gaudin C, Fournier V, Corre E, Le Corguille G, Bernay B.
- Rubio N Beltran S, Jaime I, Diego SM De, Sanz MT, Carballido JR.
- Samaranayaka AGP Li-Chan ECY
- Samuelsen TA Mjos SA, Oterhals A.
- Samuelsen TA Mjos SA, Oterhals A.
- Samuelsen TA Oterhals A.
- Sarker AK Saha D, Begum H, Zaman A, Rahman MM.
- Sathivel S Smiley S, Prinyawiwatkul W, Bechtel PJ.
- Silva JFX Ribeiro K, Silva JF, Cahu TB, Bezerra RS.
- Souissi N Bougatef A, Triki-ellouz Y, Nasri M.
- Taheri A Anvar SAA, Ahari H, Fogliano V.
- Thiansilakul Y Benjakul S, Shahidi F.
- Toledo J Botello A, Llanes JE.
- Toledo J Llanes J.
- Tomczak-Wandzel R Medrzycka K.
- Wald M Rehbein H, Beermann C, Bu�mann B, Schwarz K.
- Wald M Schwarz K, Rehbein H, Bu�mann B, Beermann C.
- Yeaman MR Yount NY.
- Zahar M Benkerroum N, Guerouali A, Laraki Y, El Yakoubi K.
- Zakaria Z Hall GM, Shama G.
- Publication venue
- 'Indian Society for Education and Environment'
- Publication date
- Field of study
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
- Author
- Abada S
- Abbas Syed R
- Abbas JD
- Abdalla M
- Abdel-Khaleq S
- Abdelrahim ASA
- Abdelrazek M
- Abdelrazik Y
- Abdi M
- Abdolrazaghi S
- Abdul-Fattah S
- Abdulla S
- Abdullah M
- Abi Aoun R
- Abid S
- Abigail S
- Abou El Ela Bourquin B
- Abousamra M
- Adabavazeh B
- Adams J
- Adams M
- Adams N
- Adcock A
- Adebambo D
- Adeboyejo O
- Adeeko ES
- Adelekan K
- Adelowo T
- Adeniken E
- Adeoye A
- Adeusi L
- Afsheen N
- Agarwal A
- Agarwal G
- Agarwal N
- Agbinya N
- Aghanenu O
- Agiotakis S
- Aguirrezabala Armbruster B
- Ahari D
- Ahmad Fuad MF
- Ahmad MA
- Ahmad NA
- Ahmadi H
- Ahmed Osman A
- Ahmed A
- Ahmed I
- Ahmed J
- Ahmed M
- Ahmed O
- Ahmed S
- Ahmed SK
- Ahmed W
- Ainsworth J
- Ainsworth K
- Aitken S
- Ajdarpasic D
- Ajekigbe F
- Akbar Z
- Akhbari M
- Akintunde A
- Akinyemi J
- Akmal A
- Akmal K
- Akram B
- Al Bahri T
- Al Bakry M
- Al Dabbagh A
- Al Rawi M
- Al Sadek Y
- Al-Hamid Z
- Al-Khafaji M
- Alam F
- Alattas A
- Alawattegama LH
- Alberts J
- Alfadhel S
- Alhwaishel K
- Ali Butt S
- Ali A
- Ali K
- Ali M
- Ali N
- Ali S
- Alim L
- Alkandari B
- Alkoot M
- Allan D
- Allan J
- Allen K
- Allen R
- Allin D
- Almoosawy SA
- Alom J
- Alsaady A
- Alsadoun L
- Alsusa H
- Alves do Canto Brum H
- Alves D
- Aly R
- Alyacoubi S
- Amakye NY
- Amarnath T
- Amin A
- Amin M
- Amini B
- Anandampillai R
- Anarfi S
- Anderson E
- Anderson P
- Anderton J
- Andrew F
- Anjum Z
- Ansar Z
- Anthony Wilkinson J
- Antypas A
- Anuar A
- Apata A
- Appanna T
- Appleton B
- Appleyard T
- Arain Z
- Aranha M
- Arnold A
- Arnold C
- Arora E
- Arrayeh A
- Arshad M
- Arshad SR
- Arthur-Quarm S
- Arumugam V
- Arwi G
- Ashai S
- Asharaf H
- Ashaye A
- Ashcroft-Quinn S
- Ashdown T
- Ashman M
- Ashok A
- Ashwell W
- Ashworth I
- Asif A
- Asvandi S
- Atherton R
- Atiyah A
- Atkins W
- Aung E
- Aung YY
- Austin T
- Ayandokun P
- Ayub H
- Azam R
- Azam Z
- Azeez Z
- Azizan N
- Azizi S
- Azlan A
- Azouaghe O
- Bachelet B
- Bacigalupo V
- Bacon H
- Badminton R
- Badran A
- Bahl S
- Bailey A
- Bain J
- Bajaj M
- Bajaj S
- Bajaj V
- Baker C
- Baker D
- Baker J
- Baker O
- Bakina C
- Balakumar V
- Balasubramanian A
- Balasubramanian N
- Bald A
- Balfour J
- Ball M
- Bandyopadhyay D
- Bandyopadhyay S
- Bangi S
- Bani W
- Bannister J
- Barabas M
- Baraza W
- Barciela C
- Bardon A
- Barham E
- Barnes R
- Barrett G
- Barrington J
- Barrington M
- Barry I
- Barry J
- Barry K
- Bartlett M
- Barton O
- Bashiti H
- Basi S
- Baskaran R
- Bassett E
- Batchelor C
- Batchelor-Parry H
- Bawa G
- Bawa JH
- Beattie M
- Beck C
- Bee F
- Beg R
- Belais F
- Belk LH
- Bellam S
- Ben-Arzi H
- Bennett T
- Bennewith R
- Berry A
- Bettoli G
- Bevis R
- Bhachoo H
- Bhadra K
- Bhandari A
- Bhangu A
- Bhardwaj R
- Bharwada Y
- Bhat A
- Bhate R
- Bhatia P
- Bhatia S
- Bhattarai S
- Bhatti M
- Bhatti S
- Bhavra K
- Bhoombla N
- Bhudia R
- Bhullar D
- Bibi F
- Biddles D
- Bilal A
- Billson E
- Bilolikar A
- Bird R
- Birnie C
- Bishop A
- Bisson E
- Bix E
- Bloom I
- Blott N
- Boaden L
- Boggon E
- Bogie E
- Bojanic C
- Bommireddy L
- Bonte A
- Borakati A
- Bosley N
- Botsa E
- Bottomley J
- Bourke E
- Bourne K
- Bowen K
- Bowes A
- Bowley D
- Boyle C
- Bradley J
- Bradshaw E
- Brady R
- Braganza J
- Bratsos S
- Brazier B
- Brazkiewicz M
- Breathnach C
- Brenac S
- Brew A
- Bridges I
- Broad G
- Broekhuizen A
- Brookes T
- Brothwood D
- Brousse de Gersigny J
- Browlee O
- Brown A
- Brown C
- Brown E
- Brown G
- Brown L
- Brown R
- Brown S
- Browne R
- Bruce D
- Bryan A
- Bryans K
- Bucknall T
- Budd W
- Budding J
- Bunni J
- Burke D
- Burns F
- Burns J
- Burrell K
- Burt G
- Burt J
- Burtle D
- Burton L
- Burton M
- Burway S
- Buxton-Hopley R
- Byrne M
- Cahya E
- Caldwell S
- Cambridge WA
- Cameron F
- Campbell A
- Campbell B
- Cann J
- Carberry E
- Carey C
- Carpenter H
- Carr W
- Carrick M
- Carroll L
- Carroll M
- Casey A
- Cavanagh S
- Chadda KR
- Chadwick T
- Chalkley M
- Chamberlain G
- Champion A
- Chan C
- Chan LH
- Chan SMZ
- Chan XHF
- Chand CP
- Chandegra A
- Chander B
- Chandrasekaran J
- Chandratreya N
- Chang C
- Chaora T
- Chapman D
- Chapman S
- Chapman T
- Chapple K
- Charalambous M
- Chatha S
- Chau CYC
- Chaudhari S
- Chawla S
- Cheah E
- Chee J
- Cheekoty P
- Cheema J
- Chellapuri A
- Chen JY
- Cheng T
- Chennupati R
- Cheong J
- Cherry C
- Cheung A
- Cheung J
- Chew D
- Chew SJHL
- Chia D
- Chia WL
- Chikomba L
- Chinta SH
- Chiong J
- Chittoor Satish NN
- Chiu C
- Chlubek M
- Chmielewski G
- Cho SH
- Choa G
- Choi NY
- Chong A
- Chong C
- Chong T
- Chong V
- Choo LY
- Choo SY
- Chopra P
- Chou WK
- Choudhry A
- Choudhry H
- Chow J
- Chow R
- Chow YW
- Chowdhury A
- Chowdhury S
- Chowdhury T
- Chrisp B
- Christie I
- Christou A
- Chu J
- Chu K
- Chu TSM
- Chu YYA
- Chung I
- Chung S
- Cinnamond A
- Cirelli C
- Clark A
- Clark F
- Clark G
- Clark L
- Clarke G
- Clayton B
- Clayton S
- Cleaver J
- Clement NS
- Clements B
- Clements JM
- Cloney M
- Coates S
- Cockroft A
- Coldwell C
- Coleman O
- Coleman S
- Colman J
- Colterjohn N
- Common J
- Common T
- Compton M
- Connachan R
- Connell B
- Constantinides M
- Conti I
- Cook A
- Cook E
- Cookey-Bresi R
- Coombe-Jones M
- Coombs A
- Cooper Drake B
- Cooper L
- Cope P
- Cope S
- Copeland L
- Cornwall H
- Corrin E
- Costa I
- Coulson A
- Coulthurst J
- Court EL
- Covell G
- Coyle J
- Creagh-Brown B
- Creissen A
- Cresswell B
- Cripps P
- Crisp E
- Crook D
- Crosbie S
- Croyle JA
- Cullen G
- Cullimore V
- Cummings D
- Cummins T
- Cundy A
- Curran E
- Curran S
- Curtis Lopez C
- Cuthbert H
- D Portela S
- D'Afflitto M
- D'Cunha Kamath A
- Dadnam F
- Dale VH
- Daniel S
- Daniell A
- Daniels M
- Dar T
- Darkwa S
- Darling H
- Datta A
- Dattani A
- Dauncey J
- Davies C
- Davies E
- Davies G
- Davies L
- Davies P
- Davies R
- Davies-kelly N
- Davis L
- Davis P
- Dawas K
- Dawson A
- De Andres Crespo M
- De Berker H
- De Carvalho L
- De Kock Jewell V
- De Soysa S
- Deans J
- Deekonda P
- Deliyannis E
- Deng A
- Dermanis A
- Desai B
- Desai N
- Deshpande A
- Devalia K
- Devi S
- Devindaran A
- Devine A
- Dexter E
- Dhar M
- Dhebri A
- Dhuga Y
- Di Traglia R
- Dickinson M
- Dickinson S
- Dilaver N
- Dinesh AA
- Dinh TH
- Dixit A
- Dixon C
- Dixon M
- Dixon Y
- Do Le HP
- Do JE
- Dobinson C
- Dodhia V
- Doherty C
- Doherty W
- Dominguez E
- Donnelly A
- Donnelly B
- Donnelly HA
- Donohue J
- Doré C
- Down B
- Doyle C
- Drake I
- Drake J
- Drew W
- Drusch B
- Dudi-Venkata NN
- Duller A
- Duque Golding J
- Durand M
- Dwaraknath M
- Eagles EJ
- Eardley N
- Easby S
- Edelsten E
- Edwards J
- Edwards M
- Edwards P
- Egoroff N
- Eichenauer CE
- Ekpete O
- El Sabawy D
- El Sheikh M
- Elawad A
- Eldridge M
- Eleni A
- Elhakim H
- Elkawafi M
- Elliott J
- Elliott JA
- Elliott M
- Ellis J
- Elmansouri A
- Elsayeh K
- Elsharkawi A
- Elzanati H
- Emmanuel T
- Emms L
- English C
- Enver M
- Epanomeritakis E
- Eriksson F
- Erotocritou M
- Evans A
- Evans B
- Evans C
- Evans E
- Evans L
- Evans N
- Ezennia K
- Fabelurin C
- Fairclough S
- Fairey M
- Faisal H
- Fan J
- Fang B
- Farah Y
- Farbood K
- Faris Mahmood H
- Farr E
- Farrelly C
- Farrugia A
- Fatimah Hussain Q
- Faulkner G
- Fawdon R
- Fay E
- Fearnhead N
- Feather A
- Fegredo D
- Feighery A
- Felstead D
- Fenton J
- Ferarrio I
- Fernando D
- Fernando P
- Ferriman A
- Ferrin S
- Feyi-Waboso J
- Field C
- Field D
- Figg K
- Finch G
- Findlay J
- Fischer F
- Fish J
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- Fisher T
- Fitzgerald C
- Flach A
- Flint J
- Fludder V
- Ford C
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- Forrest M
- Fort-Schaale A
- Fortescue L
- Foster K
- Foster-Davies H
- Foulkes A
- Fowler G
- Fox C
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- Franco Da Silva C
- Francombe J
- Franklin S
- Franklyn J
- French B
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- French R
- Frisira E
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- Fung E
- Fung HKF
- Fung YJ
- Furlepa M
- Gaba F
- Gabrel M
- Gallagher C
- Gallagher H
- Gallie R
- Galvin C
- Gamage K
- Ganapathy M
- Gandhi P
- Gandhi T
- Ganewatta Kankanamge D
- Gardener M
- Gardiner H
- Gardner M
- Garg J
- Garg S
- Gargan K
- Garland H
- Garner J
- Garwood P
- Gaston-Grubb M
- Gatumbu P
- Gaunt E
- George HA
- George S
- Georgi T
- Gercek Y
- Germani Batacchi M
- Ghazal R
- Ghose R
- Ghosh I
- Giang S
- Gibbins A
- Gibbons H
- Gibson C
- Gill D
- Gill M
- Gill N
- Gill P
- Gillespie R
- Gilliam A
- Girdlestone H
- Girish M
- Glasbey JC
- Glasson R
- Glen P
- Glover T
- Goan R
- Godhaniya J
- Goede A
- Gogna A
- Goh J
- Goldsworthy M
- Gomaa A
- Goodhew R
- Gopikrishna D
- Gornell C
- Goss J
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- Goulder L
- Goyal S
- Gravett H
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- Greasley M
- Green RL
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- Green SV
- Griffiths E
- Groves E
- Gruffydd-Davies M
- Guan Z
- Guest O
- Gujjuri R
- Gulamhussein AHM
- Gulati R
- Gunn F
- Gupta A
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- Gureviciute E
- Gurung B
- Gurung C
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- Gurung P
- Guthrie J
- Guéroult A
- Gwilliam R
- Gwozdz A
- Gwyn-Jones A
- Habib S
- Hackett N
- Hafouda Y
- Haglund C
- Hague S
- Haider S
- Haider SA
- Hainsworth P
- Haji A
- Hakim MA
- Hamilton K
- Hamlyn V
- Hampson A
- Hamstead E
- Hamza H
- Han SM
- Handa A
- Handa I
- Handley G
- Hang S
- Hanley J
- Hanna J
- Hanna N
- Hanna P
- Hansdot S
- Haq I
- Haq MZ
- Harbourne A
- Hardie W
- Hardy A
- Hardy E
- Hare N
- Harnett M
- Harris J
- Harris T
- Harrison EM
- Hart E
- Hashmi Y
- Hassan A
- Hassan F
- Hassan MR
- Hassane A
- Hatab A
- Hathaway D
- Hatoum A
- Hatt K
- Hatta S
- Havalda P
- Hawkins-Hooker L
- Hawksley J
- Hay D
- Hayes J
- Hayre J
- Healicon R
- Heath E
- Hedges J
- Henderson C
- Henderson R
- Henry-Blake C
- Hibell I
- Higginbotham G
- Higgs M
- Hill A
- Hilton M
- Hilton-Christie S
- Hinchcliffe Z
- Hird A
- Hird R
- Hirniak J
- Ho C
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- Ho JSY
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- Hoade L
- Hobson K
- Hogan A
- Hogan M
- Hollingshead J
- Hollows S
- Holmes P
- Holohan R
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- Hooper J
- Hope E
- Horner A
- Horseman L
- Horton M
- Hosfield T
- Hotouras A
- Houlden C
- Hounat A
- Howard D
- Howard N
- Howard R
- Howarth-Maddison M
- Howell KA
- Howell S
- Howells R
- Hoyle C
- Huang Y
- Hubbard E
- Hudson S
- Hughes E
- Hughes I
- Hughes JT
- Hullait R
- Humphries E
- Hunt H
- Hunter A
- Hunter I
- Hurley P
- Hurry A
- Hurt L
- Husain M
- Hussain F
- Hussain H
- Hussain N
- Hussain S
- Hussey T
- Hutchison R
- Huttman M
- Huynh L
- Hyde A
- I K
- Iacob M
- Iakovou A
- Iakovou D
- Ibrahim B
- Idris NS
- Ikotun O
- Ilyas C
- Imani-Masouleh S
- Impelliziere Licastro G
- Inpadhas V
- Ip Fung Chun N
- Iqbal H
- Iqbal M
- Iqbal R
- Iqbal Z
- Irving A
- Isaac AG
- Islam S
- Isleyen N
- Ismail E
- Ismail N
- Ismail R
- Isti C
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- Zahid M
- Zaki F
- Zakieh O
- Zalmay P
- Zaman M
- Zaman S
- Zander A
- Zeicu C
- Zeng G
- Zhang G
- Zhang M
- Zhang N
- Zhao S
- Zhao Z
- Zhu L
- Zilber E
- Zimmerman M
- Zuhairy S
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/06/2022
- Field of study
Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society