Surgical Procedure Assessment Score - Medical Algorithm

Description

Panzer et al developed the Surgical Procedure Assessment (SPA) score to evaluate adult patients prior to cardiac surgery. This can help predict patients who may have a prolonged course in the intensive care unit (ICU) after surgery. The authors are from Columbia University in New York City.

Parameters:

(1) complexity of the cardiac surgery

(2) presence of significant comorbid conditions

Surgical Complexity	Comorbid Conditions	SPA Score
low	absent	1A
low	present	1B
moderate	absent	2A
moderate	present	2B
high	NA	3

where:

• "A" designates no significant comorbid condition and "B" indicates that one or more are present.

Complexity Level	Examples
low	coronary artery bypass, valve replacement (CABG), mitral or aortic valve replacement
moderate	heart transplant, coronary artery bypass AND valve replacement
high	ventricular assist device (VAD), lung transplant

Significant comorbid conditions include:

(1) intra-aortic balloon pump

(2) left ventricular ejection fraction < 20%

(3) diabetes mellitus, severe systemic disease

(4) lung disease requiring supplement oxygen

(5) ventricular arrhythmias.

SPA Score	Median Stay in ICU
1A	1.1 days
1B	1.3 days
2A	1.6 days
2B	3.0 days
3	9.6 days

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Description

Specialty

Objective

ICD-10

Surgical Procedure Assessment (SPA) Score

Purpose: To evaluate an adult patient about to undergo cardiac surgery using the Surgical Procedure Assessment (SPA) score of Panzer et al.

Description

Specialty

Objective

ICD-10