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Postoperative Morbidity Index (PMI)

Purpose: To calculate the postoperative morbidity index (PMI) for an operative procedure.

Description

Strasberg et al developed the Postoperative Morbidity Index (PMI) to describe the severity of complications following an operative procedure. It is derived from the American College of Surgeons' National Surgical Quality Improvement Program and Accordion Severity Grading System. The authors are from Washington University in St. Louis.

 


 

Accordion Grade

Severity Weight

1

0.11

2

0.26

3

0.37

4

0.60

5

0.79

6

1.00

 

postoperative morbidity index =

= A / (total population undergoing the procedure)

 

A =

= (0.11 * (number of patients with Grade 1 complications)) + (0.26 * (number of patients with Grade 2 complications)) + (0.37 * (number of patients with Grade 3 complications)) + (0.60 * (number of patients with Grade 4 complications)) + (0.79 * (number of patients with Grade 5 complications)) + (number of patients with Grade 6 complications)

 

where:

• The handling of a patient with multiple complications is a bit unclear. One option is to grade only the most severe complication. The other option is to score each complication. However, since the maximum MPI is 1.000, it assumed that only the highest grade is used.

 

The MPI ranges from 0.000 (no complications) to 1.000 (100% mortality rate).

 

The MPI can be used to report weighted severity spectragrams for each type of surgical procedure, which shows the impact of each grade of complications on overall morbidity.


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Objective

ICD-10