Background
Methods
LAS VEGAS study
Data collection
Endpoints
Statistical analysis
Results
All Patients | Brain | Spine | p value | All patients | PPC | No PPC | p value | All patients | ARISCAT < 26 | ARISCAT ≥ 26 | p value | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
n (%) | 784 (100) | 376 (48) | 408 (52) | 777 (100.0) | 81 (10.4) | 696 (89.6) | 548 (73.3) | 200 (26.7) | 748 (100.0) | |||
Demographics | ||||||||||||
Age, years, mean (SD) | 53 (16) | 52 (16) | 54 (15) | 0.104 | 53 (16) | 59 (15) | 52 (16) | 0.000 | 50 (15) | 51 (15) | 63 (16) | 0.000 |
Gender, n (%) | ||||||||||||
Male | 392 (50) | 183 (48.7) | 209 (51.2) | 0.060 | 392 (50.5) | 37 (45.7) | 355 (51.0) | 0.072 | 285 (52.0) | 97 (48.5) | 382 (51.1) | 0.065 |
Ethnicity, n (%) | ||||||||||||
Black | 2 (0.3) | 0 (0.0) | 2 (0.5) | 2 (0.3) | 2 (2.5) | 0 (0.0) | 1 (0.2) | 1 (0.5) | 2 (0.3) | 0.663 | ||
Caucasian | 709 (90.4) | 340 (90.4) | 369 (90.4) | 704 (90.6) | 71 (87.7) | 633 (90.9) | 493 (90.0) | 183 (91.5) | 676 (90.4) | |||
Asian | 4 (0.5) | 1 (0.3) | 3 (0.7) | 4 (0.5) | 1 (1.2) | 3 (0.4) | 4 (0.7) | 0 (0.0) | 4 (0.5) | |||
Other | 33 (4.2) | 13 (3.5) | 20 (4.9) | 33 (4.2) | 2 (2.5) | 31 (4.5) | 26 (4.7) | 6 (3.0) | 32 (4.3) | |||
Anthropometry | ||||||||||||
Height, cm, mean (SD) | 170 (10) | 170 (10) | 170 (9) | 0.416 | 170 (10) | 169 (10) | 170 (10) | 0.421 | 170 (10) | 169 (10) | 170 (10) | 0.243 |
Weight, kg, mean (SD) | 79 (17) | 80 (18) | 78 (16) | 0.309 | 79 (17) | 80 (18) | 79 (17) | 0.597 | 79 (17) | 79 (17) | 79 (17) | 0.677 |
BMI, kg/m2, mean (SD) | 27.3 (5.8) | 27.7 (6.6) | 27.0 (4.9) | 0.148 | 27.3 (5.8) | 28.3 (6.5) | 27.2 (5.7) | 0.141 | 27.3 (6.0) | 27.4 (5.0) | 27.3 (5.8) | 0.874 |
Co-morbidities, n (%) | ||||||||||||
Co-morbidities | 161 (20.5) | 84 (22.3) | 77 (18.9) | 0.230 | 160 (20.6) | 30 (37.0) | 130 (18.7) | 0.000 | 98 (17.9) | 59 (29.5) | 157 (21.0) | 0.001 |
COPD | 47 (6.0) | 21 (5.6) | 26 (6.4) | 0.643 | 47 (6.0) | 8 (9.9) | 39 (5.6) | 0.127 | 32 (5.8) | 15 (7.5) | 47 (6.3) | 0.407 |
Respiratory | 19 (2.4) | 8 (2.1) | 11 (2.7) | 0.605 | 19 (2.4) | 5 (6.2) | 14 (2.0) | 0.022 | 12 (2.2) | 7 (3.5) | 19 (2.5) | 0.313 |
Liver cirrhosis | 4 (0.5) | 2 (0.5) | 2 (0.5) | 0.935 | 4 (0.5) | 0 (0.0) | 4 (0.6) | 0.494 | 3 (0.5) | 1 (0.5) | 4 (0.5) | 0.937 |
Chronic kidney failure | 16 (2.0) | 4 (1.1) | 12 (2.9) | 0.063 | 16 (2.1) | 4 (4.9) | 12 (1.7) | 0.054 | 6 (1.1) | 9 (4.5) | 15 (2.0) | 0.003 |
Heart failure | 45 (5.7) | 27 (7.2) | 18 (4.4) | 0.096 | 45 (5.8) | 10 (12.3) | 35 (5.0) | 0.008 | 29 (5.3) | 14 (7.0) | 43 (5.7) | 0.374 |
Neuro disease | 12 (1.5) | 8 (2.1) | 4 (1.0) | 0.191 | 12 (1.5) | 2 (2.5) | 10 (1.4) | 0.476 | 11 (2.0) | 1 (0.5) | 12 (1.6) | 0.146 |
Pre-operative medical history | ||||||||||||
ASA physical status, n (%) | 214 (27.4) | 96 (25.5) | 118 (29.1) | 0.007 | 208 (26.8) | 14 (17.5) | 194 (27.9) | 0.000 | 165 (30.1) | 29 (14.6) | 194 (26.0) | 0.000 |
ASA I | 395 (50.5) | 178 (47.3) | 217 (53.4) | 395 (51.0) | 33 (41.3) | 362 (52.1) | 292 (53.3) | 90 (45.2) | 382 (51.1) | |||
ASA II | 395 (50.5) | 178 (47.3) | 217 (53.4) | 153 (19.7) | 28 (35.0) | 125 (18.0) | 85 (15.5) | 68 (34.2) | 153 (20.5) | |||
ASA III | 154 (19.7) | 87 (23.1) | 67 (16.5) | 18 (2.3) | 5 (6.3) | 13 (1.9) | 6 (1.1) | 11 (5.5) | 17 (2.3) | |||
ASA IV | 18 (2.3) | 14 (3.7) | 4 (1.0) | 1 (0.1) | 0 (0.0) | 1 (0.1) | 0 (0.0) | 1 (0.5) | 1 (0.1) | |||
ASA V | 1 (0.1) | 1 (0.3) | 0 (0.0) | 208 (26.8) | 14 (17.5) | 194 (27.9) | 165 (30.1) | 29 (14.6) | 194 (26.0) | |||
Functional status, n (%) | 0.004 | 0.000 | 0.006 | |||||||||
Independent | 708 (90.3) | 327 (87.0) | 381 (93.4) | 702 (90.3) | 67 (82.7) | 635 (91.2) | 506 (92.3) | 168 (84.0) | 674 (90.1) | |||
Partially dependent | 62 (7.9) | 38 (10.1) | 24 (5.9) | 62 (8.0) | 12 (14.8) | 50 (7.2) | 33 (6.0) | 27 (13.5) | 60 (8.0) | |||
Totally dependent | 13 (1.7) | 11 (2.9) | 2 (0.5) | 12 (1.5) | 2 (2.5) | 10 (1.4) | 8 (1.5) | 5 (2.5) | 13 (1.7) | |||
ARISCAT score, median (IQR) | 215 (27.4) | 102 (27.1) | 113 (27.7) | 0.000 | 16 (3; 26) | 23 (11; 32) | 16 (3; 24) | 0.002 | 8 (3; 18) | 31 (26; 37) | 16 (3; 26) | 0.000 |
Smoking, n (%) | 40 (5.1) | 23 (6.1) | 17 (4.2) | 0.859 | 214 (27.5) | 22 (27.2) | 192 (27.6) | 0.442 | 165 (30.1) | 44 (22.0) | 209 (27.9) | 0.029 |
Transfusion (< 24 h), n (%) | 5 (0.6) | 3 (0.8) | 2 (0.5) | 0.215 | 39 (5.0) | 6 (7.4) | 33 (4.7) | 0.000 | 16 (2.9) | 22 (11.0) | 38 (5.1) | 0.000 |
RBC transfusion (< 24 h) | 28 (3.6) | 16 (4.3) | 12 (2.9) | 0.589 | 5 (0.6) | 1 (1.2) | 4 (0.6) | 0.722 | 1 (0.2) | 4 (2.0) | 5 (0.7) | 0.007 |
Respiratory infection (<30d), n (%) | 1 (0.1) | 0 (0.0) | 1 (0.2) | 0.322 | 28 (3.6) | 3 (3.7) | 25 (3.6) | 0.002 | 7 (1.3) | 19 (9.5) | 26 (3.5) | 0.000 |
Laboratory tests and vital signs | ||||||||||||
Pre-operative values | ||||||||||||
SpO2, %, median (IQR) | 97 (96; 99) | 97 (96; 98) | 97 (96; 99) | 0.230 | 97 (96; 99) | 97 (95; 98) | 98 (96; 99) | 0.002 | 98 (96; 99) | 96 (94; 98) | 97 (96; 99) | 0.000 |
Hb, (g/dL), mean (SD) | 13.8 (1.8) | 13.8 (1.8) | 13.9 (1.8) | 0.540 | 13.8 (1.8) | 13.7 (2.0) | 13.8 (1.8) | 0.442 | 14.0 (1.6) | 13.3 (2.1) | 13.8 (1.8) | 0.000 |
WBC, (cell/mm3), mean (SD) | 7879 (3497) | 8199 (3097) | 7568 (3825) | 0.019 | 7891 (3503) | 9261 (6168) | 7721 (2978) | 0.000 | 7696 (3362) | 8438 (3845) | 7905 (3518) | 0.015 |
Creatinine, (mg/dL), mean (SD) | 0.89 (0.69) | 0.90 (0.86) | 0.88 (0.49) | 0.758 | 0.89 (0.69) | 0.87 (0.28) | 0.90 (0.73) | 0.722 | 0.87 (0.59) | 0.95 (0.91) | 0.89 (0.70) | 0.192 |
Surgical characteristics | ||||||||||||
Condition, n (%) | 0.318 | 0.140 | 0.000 | |||||||||
Elective | 717 (91.5) | 338 (89.9) | 379 (92.9) | 712 (91.6) | 73 (90.1) | 639 (91.8) | 513 (93.6) | 172 (86.0) | 685 (91.6) | |||
Urgency | 50 (6.4) | 28 (7.4) | 22 (5.4) | 49 (6.3) | 4 (4.9) | 45 (6.5) | 31 (5.7) | 16 (8.0) | 47 (6.3) | |||
Emergency | 17 (2.2) | 10 (2.7) | 7 (1.7) | 16 (2.1) | 4 (4.9) | 12 (1.7) | 4 (0.7) | 12 (6.0) | 16 (2.1) | |||
Planned duration, hours, n (%) | 0.000 | 0.000 | 0.000 | |||||||||
0 | 1 (0.1) | 1 (0.3) | 0 (0.0) | 1 (0.1) | 0 (0.0) | 1 (0.1) | ||||||
≤ 2 | 432 (55.1) | 186 (49.5) | 246 (60.3) | 426 (54.8) | 36 (44.4) | 390 (56.0) | 378 (69.0) | 25 (12.5) | 403 (53.9) | |||
2–3 | 201 (25.6) | 90 (23.9) | 111 (27.2) | 201 (25.9) | 15 (18.5) | 186 (26.7) | 124 (22.6) | 73 (36.5) | 197 (26.3) | |||
> 3 | 150 (19.1) | 99 (26.3) | 51 (12.5) | 149 (19.2) | 30 (37.0) | 119 (17.1) | 46 (8.4) | 102 (51.0) | 148 (19.8) | |||
Antibiotic prophylaxis, n (%) | 711 (90.9) | 338 (90.1) | 373 (91.6) | 0.462 | 705 (91.0) | 74 (91.4) | 631 (90.9) | 0.897 | 500 (91.4) | 184 (92.0) | 684 (91.6) | 0.796 |
Ventilation variables and intraoperative characteristics
All Patients | Brain | Spine | p value | All patients | PPC | No PPC | p value | All patients | ARISCAT < 26 | ARISCAT ≥ 26 | p value | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
n (%) | 784 (100.0) | 376 (48.0) | 408 (52.0) | 777 (100.0) | 81 (10.4) | 696 (89.6) | 748 (100.0) | 548 (73.3) | 200 (26.7) | |||
Ventilation and vital signs | ||||||||||||
Ventilatory mode, n (%) | 0.000 | 0.376 | 0.452 | |||||||||
Volume controlled | 494 (63.8) | 259 (70.2) | 235 (58.0) | 488 (63.5) | 50 (64.1) | 438 (63.5) | 467 (63.2) | 341 (62.9) | 126 (64.0) | |||
Pressure controlled | 149 (19.3) | 42 (11.4) | 107 (26.4) | 149 (19.4) | 20 (25.6) | 129 (18.7) | 146 (19.8) | 112 (20.7) | 34 (17.3) | |||
Pressure support | 3 (0.4) | 2 (0.5) | 1 (0.2) | 3 (0.4) | 0 (0.0) | 3 (0.4) | 3 (0.4) | 1 (0.2) | 2 (1.0) | |||
Spontaneous | 64 (8.3) | 21 (5.7) | 43 (10.6) | 64 (8.3) | 4 (5.1) | 60 (8.7) | 60 (8.1) | 42 (7.7) | 18 (9.1) | |||
Other | 64 (8.3) | 45 (12.2) | 19 (4.7) | 64 (8.3) | 4 (5.1) | 60 (8.7) | 63 (8.5) | 46 (8.5) | 17 (8.6) | |||
VT, ml, median (IQR) | 510 (475; 575) | 511 (475; 584) | 506 (471; 562) | 0.183 | 510 (475; 575) | 500 (458; 560) | 513 (475; 575) | 0.096 | 510 (475; 572) | 506 (475; 565) | 525 (480; 590) | 0.142 |
VT, (ml/kg PBW), median (IQR) | 8.0 (7.3; 9.0) | 8.2 (7.3; 9.1) | 8.0 (7.2; 8.9) | 0.150 | 8.0 (7.3; 9.0) | 7.7 (7.0; 8.8) | 8.1 (7.3; 9.0) | 0.060 | 8.0 (7.3; 9.0) | 8.0 (7.3; 9.0) | 8.0 (7.3; 9.1) | 0.420 |
PPeak, cmH2O, median (IQR) | 18 (15; 21) | 18 (15; 21) | 18 (16; 21) | 0.225 | 18 (15; 21) | 18 (16; 21) | 18 (15; 21) | 0.183 | 18 (15; 21) | 18 (15; 21) | 18 (16; 21) | 0.061 |
PPlateau, cmH2O, median (IQR) | 16 (14; 19) | 16 (14; 19) | 16 (14; 18) | 0.201 | 16 (14; 19) | 17 (14; 19) | 16 (14; 19) | 0.150 | 16 (14; 19) | 16 (14; 18) | 17 (15; 19) | 0.012 |
PEEP, cmH2O, median (IQR) | 5.0 (3.0; 5.0) | 5.0 (4.0; 5.0) | 5.0 (3.0; 5.0) | 0.669 | 5.0 (3.0; 5.0) | 5.0 (4.0; 5.0) | 5.0 (3.0; 5.0) | 0.225 | 5.0 (3.0; 5.0) | 5.0 (3.0; 5.0) | 5.0 (3.3; 5.0) | 0.156 |
DP, cmH2O, median (IQR) | 12 (11; 15) | 13 (11; 15) | 12 (10; 16) | 0.585 | 12 (11; 15) | 13 (11; 15) | 12 (11; 15) | 0.201 | 12 (11; 15) | 12 (11; 15) | 14 (11; 17) | 0.009 |
RR, bpm, mean (SD) | 12.0 (1.5) | 12.1 (1.5) | 12.0 (1.4) | 0.237 | 12.0 (1.5) | 12.1 (1.7) | 12.0 (1.4) | 0.669 | 12.0 (1.4) | 12.1 (1.3) | 11.9 (1.7) | 0.188 |
FiO2, %, median (IQR) | 50 (43; 65) | 50 (40; 60) | 50 (44; 68) | 0.021 | 50 (43; 64) | 50 (46; 65) | 50 (42; 63) | 0.585 | 50 (43; 65) | 50 (43; 70) | 50 (45; 60) | 0.143 |
SpO2, %, median (IQR) | 99 (98; 100) | 99 (99; 100) | 99 (98; 100) | 0.169 | 99 (98; 100) | 99 (98; 100) | 99 (98; 100) | 0.237 | 99 (98; 100) | 99 (99; 100) | 99 (98; 100) | 0.069 |
ETCO2, mmHg, mean (SD) | 33 (4) | 32 (4) | 33 (5) | 0.001 | 33 (4) | 33 (4) | 33 (5) | 0.554 | 33 (4) | 33 (4) | 33 (5) | 0.549 |
MP, J/min, median (IQR) | 6.6 (4.9; 9.2) | 6.9 (5.0; 10.3) | 6.2 (4.8; 7.8) | 0.058 | 6.6 (4.9; 9.2) | 6.1 (4.8; 10.5) | 6.6 (4.9; 9.1) | 0.856 | 6.6 (4.9; 9.3) | 6.6 (4.9; 8.6) | 6.7 (5.1; 10.8) | 0.230 |
MAP, mmHg, mean (SD) | 80 (12) | 79 (12) | 80 (13) | 0.083 | 79 (12) | 78 (11) | 80 (13) | 0.021 | 79 (12) | 79 (12) | 80 (13) | 0.212 |
Heart rate, bpm, mean (SD) | 71 (12) | 69 (12) | 72 (12) | 0.004 | 71 (12) | 68 (12) | 71 (12) | 0.169 | 70 (12) | 71 (12) | 70 (13) | 0.355 |
RM, n (%) | 54 (6.9) | 29 (7.8) | 25 (6.1) | 0.365 | 54 (6.9) | 29 (7.8) | 25 (6.1) | 0.365 | 51 (6.8) | 36 (6.6) | 15 (7.5) | 0.664 |
Anesthesia characteristics | ||||||||||||
Opioids, n (%) | ||||||||||||
No | 2 (0.3) | 0 (0.0) | 2 (0.5) | 2 (0.3) | 0 (0.0) | 2 (0.5) | 90 (12.0) | 65 (11.9) | 25 (12.5) | |||
Yes | 782 (99.7) | 376 (100.0) | 406 (99.5) | 0.174 | 782 (99.7) | 376 (100.0) | 406 (99.5) | 0.629 | 746 (99.7) | 546 (99.6) | 200 (100.0) | 0.392 |
Opioids type, n (%) | 0.000 | 0.055 | 0.836 | |||||||||
Short acting | 221 (28.2) | 137 (36.4) | 84 (20.6) | 220 (28.3) | 20 (24.7) | 200 (28.7) | 2 (0.3) | 2 (0.4) | 0 (0.0) | |||
Long acting | 466 (59.4) | 189 (50.3) | 277 (67.9) | 460 (59.2) | 43 (53.1) | 417 (59.9) | 212 (28.3) | 154 (28.1) | 58 (29.0) | |||
Total fluids, ml, median (IQR) | 1500 (1000; 2000) | 1500 (1000; 2000) | 1500 (1000; 2000) | 0.022 | 1500 (1000; 2000) | 1800 (1200; 2125) | 1500 (1000; 2000) | 0.001 | 1500 (1000; 2000) | 1300 (1000; 2000) | 2000 (1100; 3000) | 0.000 |
Cristalloids | 1175 (1000; 2000) | 1200 (1000; 2000) | 1000 (1000; 1500) | 0.012 | 1200 (1000; 2000) | 1500 (1000; 2050) | 1000 (1000; 2000) | 0.000 | 1200 (1000; 2000) | 1000 (1000; 1500) | 1725 (1000; 2475) | 0.000 |
Colloids | 0.0 (0.0; 500.0) | 0.0 (0.0; 500.0) | 0.0 (0.0; 500.0) | 0.649 | 0.0 (0.0; 500.0) | 0.0 (0.0; 500.0) | 0.0 (0.0; 500.0) | 0.719 | 0.0 (0.0; 500.0) | 0.0 (0.0; 125.0) | 0.0 (0.0; 500.0) | 0.649 |
Occurrence of PPCs, intraoperative complications and outcomes
All Patients | Brain | Spine | p value | All patients | PPC | No PPC | p value | All patients | ARISCAT < 26 | ARISCAT ≥ 26 | p value | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
n (%) | 784 (100.0) | 376 (48.0) | 408 (52.0) | 777 (100.0) | 81 (10.4) | 696 (89.6) | 748 (100.0) | 548 (73.3) | 200 (26.7) | |||
PPCs, n (%) | ||||||||||||
PPCs | 81 (10.4) | 46 (12.4) | 35 (8.6) | 0.085 | 777 (100.0) | 81 (10.4) | 696 (89.6) | 0.000 | 80 (10.8) | 43 (7.9) | 37 (18.6) | 0.000 |
Need of oxygen | 69 (8.9) | 38 (10.2) | 31 (7.6) | 0.202 | 81 (10.4) | 81 (100.0) | 0 (0.0) | 0.000 | 68 (9.2) | 39 (7.2) | 29 (14.6) | 0.002 |
Respiratory failure | 14 (1.8) | 8 (2.2) | 6 (1.5) | 0.478 | 69 (8.9) | 69 (85.2) | 0 (0.0) | 0.000 | 14 (1.9) | 6 (1.1) | 8 (4.0) | 0.010 |
NIV | 9 (1.2) | 4 (1.2) | 5 (1.2) | 0.963 | 14 (1.8) | 14 (17.3) | 0 (0.0) | 0.000 | 9 (1.3) | 7 (1.3) | 2 (1.1) | 0.801 |
ARDS | 1 (0.1) | 1 (0.3) | 0 (0.0) | 0.295 | 9 (1.2) | 5 (6.3) | 4 (0.6) | 0.003 | 1 (0.1) | 0 (0.0) | 1 (0.5) | 0.098 |
Pneumothorax | 1 (0.1) | 1 (0.3) | 0 (0.0) | 0.295 | 1 (0.1) | 1 (1.2) | 0 (0.0) | 0.003 | 1 (0.1) | 0 (0.0) | 1 (0.5) | 0.098 |
Secondary outcomes, n (%) | ||||||||||||
Severe PPCs | 19 (2.4) | 13 (3.5) | 6 (1.5) | 0.068 | 19 (2.4) | 19 (23.5) | 0 (0.0) | 0.000 | 19 (2.6) | 6 (1.1) | 13 (6.5) | 0.000 |
Intra-operative complications | 344 (43.9) | 154 (41.1) | 190 (46.6) | 0.121 | 342 (44.1) | 46 (56.8) | 296 (42.6) | 0.015 | 336 (44.9) | 237 (43.2) | 99 (49.5) | 0.128 |
Desaturation | 38 (4.9) | 23 (6.1) | 15 (3.7) | 0.110 | 37 (4.8) | 11 (13.6) | 26 (3.7) | 0.000 | 36 (4.8) | 21 (3.8) | 15 (7.5) | 0.038 |
Unplanned RMs | 25 (3.2) | 15 (4.0) | 10 (2.5) | 0.220 | 24 (3.1) | 5 (6.2) | 19 (2.7) | 0.091 | 22 (2.9) | 12 (2.2) | 10 (5.0) | 0.043 |
Pressure reduction | 25 (3.2) | 11 (2.9) | 14 (3.4) | 0.692 | 25 (3.2) | 3 (3.7) | 22 (3.2) | 0.795 | 22 (2.9) | 17 (3.1) | 5 (2.5) | 0.666 |
Flow limitation | 5 (0.6) | 3 (0.8) | 2 (0.5) | 0.590 | 4 (0.5) | 1 (1.3) | 3 (0.4) | 0.322 | 4 (0.5) | 2 (0.4) | 2 (1.0) | 0.289 |
Hypotension | 275 (35.1) | 117 (31.2) | 158 (38.7) | 0.028 | 274 (35.3) | 34 (42.0) | 240 (34.5) | 0.185 | 270 (36.1) | 197 (35.9) | 73 (36.5) | 0.890 |
Vasopressors | 245 (31.3) | 104 (27.7) | 141 (34.6) | 0.040 | 244 (31.4) | 37 (45.7) | 207 (29.8) | 0.004 | 242 (32.4) | 168 (30.7) | 74 (37.0) | 0.101 |
New arrhythmias | 9 (1.1) | 6 (1.6) | 3 (0.7) | 0.257 | 9 (1.2) | 0 (0.0) | 9 (1.3) | 0.303 | 9 (1.2) | 5 (0.9) | 4 (2.0) | 0.227 |
Hospital LOS, days, median (IQR) | 2 (1; 5) | 2 (1; 5) | 2 (1; 5) | 0.993 | 2 (1; 5) | 3 (1; 5) | 2 (1; 5) | 0.447 | 2 (1; 5) | 2 (1; 5) | 3 (1; 5) | 0.033 |
Hospital mortality | 5 (0.7) | 4 (1.2) | 1 (0.3) | 0.145 | 5 (0.7) | 1 (1.3) | 4 (0.6) | 0.500 | 5 (0.7) | 1 (0.2) | 4 (2.2) | 0.006 |