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Nomogram of Dalton et al for Predicting 30-Day Postoperative Mortality Following Noncardiac Surgery

Purpose: To predict 30-day mortality following noncardiac surgery using the nomogram of Dalton et al.

Description

Dalton et al reported 2 nomograms for predicting 30 day morbidity and mortality following noncardiac surgery. The model for mortality can help to identify a patient for whom surgery may be particularly hazardous. The authors are from the Cleveland Clinic and McMaster University.


Each CPT code was assigned a Proceedural Severity Score (PSS), which is a univariable score measuring procedure-associated risks.

 

Patient selection: noncardiac surgery and age from 10 to 90 years

 

Parameters:

(1) age in years

(2) ASA physical status

(3) Procedural Severity Score for the surgical CPT (available at links.lww.com/ALN/A738

 

Total Score

Points

< 10

NA

10 to 60

(-0.001321 * ((age)^2)) + (0.3139 * (age)) - 3

60 to 90

(0.00425 * ((age)^2)) - (0.2285 * (age)) + 9.475

> 90

NA

 

 

ASA Status

Points

ASA 1

0

ASA 2

7.6

ASA 3

21

ASA 4

34

ASA 5

48

 

total score =

= (points for age) + (points for ASA status) + (points for PSS)

 

Total Score

30-Day Mortality

< 109

< 1%

109 to 132

(0.01786 * ((points)^2)) - (3.92 * (points)) + 216.2

132 to 161

(0.03284 * ((points)^2)) - (7.51 * (points)) + 428.7

161 to 170

(-0.05234 * ((points)^2)) + (18.98 * (points)) - 1628

 


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Specialty

Objective

ICD-10