Description

Kuo et al developed models for predicting death in moribund patients undergoing general surgery. These can help to advise family members on the risks faced by the patients. The authors are from the University of Pennsylvania.


 

Patient selection: moribund general surgical being operated on during the first 24 hours after admission >= 20 years of age

 

Types of surgery: chest wall/thoracotomy, vascular, abdominopelvic, skin/soft tissue

 

Outcome: death

 

Parameters:

(1) age in years

(2) functional status

(3) dialysis within past 30 days

(4) myocardial infarction (AMI) within past 6 months

(5) ventilator dependency

 

Parameter

Findings

Points

age in years

20 to 59 years

0

 

60 to 79 years

2

 

>= 80 years

3

functional status

fully dependent

2

 

partially or fully independent

0

dialysis

no

0

 

yes

1

AMI

no

0

 

yes

1

ventilator dependent

no

0

 

yes

2

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 9

• The higher the score the greater the risk of mortality.

 

Score

Mortality

0 or 1

23-29%

2

35-41%

3

44-45%

4

47-55%

5

55-62%

6

54-62%

7

58-72%

8 or 9

76-78%

 


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