Roshanov et al reported the BIMS score for preoperative assessment of a patient undergoing noncardiac surgery. The authors are from multiple institutions in Canada, the United States and South Africa.
BIMS refers to Bleeding Independently associated with Mortality after noncardiac Surgery
Patient selection: noncardiac surgery
Criteria for BIMS - one or more of the following during or within 30 days of surgery:
(1) bleeding that leads to a postoperative hemoglobin less than 70 g/L
(2) bleeding that results in blood transfusion
(3) bleeding that is judged to be a direct cause of death
Parameters:
(1) preoperative hemoglobin in g/L
(2) surgical technique
(3) type of surgery with regards to bleeding risk
|
Parameter
|
Finding
|
Points
|
|
preoperative hemoglobin
|
>= 120 g/L
|
0
|
|
|
< 120 g/L
|
1
|
|
surgical technique
|
endoscopic
|
0
|
|
|
open
|
1
|
|
type of surgery
|
high bleeding risk
|
1
|
|
|
low to moderate bleeding risk
|
0
|
where:
• Surgery associated with high bleeding risk includes: thoracic aorta reconstruction, aorto-iliac reconstruction, peripheral vascular reconstruction without aortic cross-clamping, complex visceral resection, partial or total colectomy, stomach surgery, major head and neck sureryfor non-thyroid tumor, urologic or gynecologic visceral resection or cytoreduction, radical hysterectomy or prostatectomy, major hip or pelvic surgery, internal fixation of the femur, knee arthroplasty, above-the-knee amputation, craniotomy, major spine surgery.
score =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
|
Score
|
Risk of BIMS
|
|
0
|
3.8%
|
|
1
|
3,8%
|
|
2
|
22.9%
|
|
3
|
58.4%
|
Performance:
• The area under the ROC curve is 0.84.
