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NARCO Score for Preoperative Risk Assessement in Children

Purpose: To evaluate a pediatric patient prior to surgery using the NARCO score of Malviya et al.

Description

Malviya et al reported the NARCO score for determining perioperative risk assessment in children. This can help to identify pediatric patients who may be poor surgical candidates. The authors are from the University of Michigan.


Parameters:

(1) neurological status (N)

(2) airway (A): anatomy and neck mobility

(3) respiratory system (R)

(4) cardiac system (C)

(5) other (O): hepatic, renal, musculoskeletal, gastrointestinal

 

Parameter

Finding

Points

neurologic status

normal

0

 

mild to moderate problem

1

 

severe problem

2

airway

normal

0

 

mild to moderate problem

1

 

severe problem

2

respiratory system

normal

0

 

mild to moderate problem

1

 

severe problem

2

cardiac system

normal

0

 

mild to moderate problem

1

 

severe problem

2

other

normal

0

 

mild to moderate problem

1

 

severe problem

2

 

 

Type of Procedure

Surgical Severity Score

non-invasive diagnostic procedure; superficial or peripheral surgery with expected blood loss minimal

A

invasive diagnostic or therapeutic procedure; airway procedure; moderate blood loss anticipated; emergency surgery

B

major surgery and/or excessive blood loss anticipated

C

organ donor

D

 

total score =

= SUM(points for all 5 parameters)

 

Total Score

Number of Items Scored 2 Points

Grade

0 to 3

0

I

4 or 5

0

II

6 to 8

NA

III

any

1 or more

III

9 or 10

NA

IV

 

 

Grade

Surgical Risk

I

low; ambulatory surgery candidate

II

moderate; may or may not require more aggressive management

III

high; requires aggressive management

IV

poor anesthesia risk; may or may not survive surgery

 


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Specialty

Objective

ICD-10