Murphy et al developed a simple score for estimating the risk for complications following laparoscopic cholecystectomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Massachusetts in Worcester, Massachusetts.
Patient selection: laparoscopic cholecystectomy
Outcome: major in-hospital complication (postoperative infection, myocardial infarction, aspiration pneumonia, deep vein thrombosis or pulmonary embolism, pulmonary compromise, gastrointestinal tract hemorrhage, dehiscence at surgical site, laceration or perforation)
Parameters:
(1) gender
(2) age in years
(3) Charlson comorbidity index (Romano adaptation)
(4) biliary tract inflammation (cholangitis)
(5) admission type
(6) hospital type
|
Parameter |
Finding |
Points |
|
Gender |
female |
0 |
|
|
male |
1 |
|
Age |
< 35 years |
0 |
|
|
35 to 64 years |
3 |
|
|
>= 65 years |
5 |
|
Charlson index |
0 |
0 |
|
|
1 |
4 |
|
|
2 |
6 |
|
|
>= 3 |
7 |
|
Inflammation |
no |
0 |
|
|
yes |
1 |
|
admission type |
elective |
0 |
|
|
emergent |
3 |
|
hospital type |
teaching |
0 |
|
|
non-teaching |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score 18
• The higher the score the greater the risk for complications following surgery.
|
Total Score |
Percent Complications |
|
<= 6 |
3.2% |
|
7 to 13 |
6.3% |
|
>= 14 |
13.5% |
Specialty: Anesthesiology
