Predicting Postoperative Outcomes With a Simple Scoring System
Predicting Postoperative Outcomes With a Simple Scoring System
Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ
J Am Coll Surg. 2007;204:201-208
The aim of this single institution report was to develop a simple, reliable scoring system to help surgeons evaluate a patient's immediate postoperative status. By combining only 3 variables (blood loss, lowest heart rate, and lowest mean arterial pressure during surgery), the study authors developed and validated a 10-point score strongly predictive of postoperative death or major complication. For patients undergoing general surgical or vascular procedures with a low score, 59% died or had a major complication. In contrast, only 4% of high-scoring patients died or developed major complications (P < .0001).
This simple, 10-point scoring system can help surgeons assess the risk for postoperative death or complications. Containing only 3 variables, it is easy to calculate, unlike more sophisticated systems, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score. This scoring system, when validated in other centers, should afford an opportunity to improve outcomes and increase safety for patients undergoing major surgery.
Abstract
An Apgar Score for Surgery
Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ
J Am Coll Surg. 2007;204:201-208
Summary
The aim of this single institution report was to develop a simple, reliable scoring system to help surgeons evaluate a patient's immediate postoperative status. By combining only 3 variables (blood loss, lowest heart rate, and lowest mean arterial pressure during surgery), the study authors developed and validated a 10-point score strongly predictive of postoperative death or major complication. For patients undergoing general surgical or vascular procedures with a low score, 59% died or had a major complication. In contrast, only 4% of high-scoring patients died or developed major complications (P < .0001).
Viewpoint
This simple, 10-point scoring system can help surgeons assess the risk for postoperative death or complications. Containing only 3 variables, it is easy to calculate, unlike more sophisticated systems, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score. This scoring system, when validated in other centers, should afford an opportunity to improve outcomes and increase safety for patients undergoing major surgery.
Abstract
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