Sadot et al developed a simple score for predicting the risk of intra-abdominal infection following colorectal surgery. This can help to identify which patients do or do not need more aggressive management. The authors are from Memorial Sloan Kettering Cancer Center in New York City.
Patient selection: colorectal cancer
Outcome: intra-abdominal infection (anastomotic leak, abscess, peritonitis)
Parameters:
(1) serum inorganic phosphorus on day 3 after surgery
(2) white blood cell count on day 3 after surgery
(3) body mass index (BMI) in kg per square meter
(4) combined liver surgery
(5) estimated blood loss in mL
|
Parameter |
Finding |
Points |
|
serum inorganic phosphorus |
normal |
0 |
|
|
below normal (hypophosphatemia) |
1 |
|
WBC count |
normal |
0 |
|
|
elevated |
1 |
|
BMI |
<= 30 kg per square m |
0 |
|
|
> 30 kg per square m |
1 |
|
combined liver surgery |
no |
0 |
|
|
yes |
1 |
|
estimated blood loss |
<= 440 mL |
0 |
|
|
> 440 mL |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of intra-abdominal infection.
|
Score |
Percent |
Risk |
|
0 or 1 |
5% |
low |
|
2 |
9% |
moderate |
|
3 |
15% |
moderate to high |
|
4 |
17% |
high |
|
5 |
20% |
high |
Performance:
• The area under the ROC curve is 0.66.
Specialty: Infectious Diseases
