Berry et al reported a classification and regression tree (CART) model for predicting postoperative physiologic decline in a pediatric patient undergoing elective surgery. The authors are from Boston Children's Hospital, Harvard Medical School, Northeastern University and Stanford University.
Patient selection: age 2 to 15 years, elective surgery
Outcome: risk of physiologic decline (compromise in cardiovascular, respiratory and/or neurologic systems)
Parameters:
(1) procedure risk
(2) active health issue
(3) chronic comorbid condition (life-limiting health conditions associated with severe functional limitations and high morbidity)
(4) number of chronic medications taken at home
Procedure Risk
Active Health Issue
Chronic Comorbid
Home Medications
Physiologic Decline
low or moderate
no
NA
NA
9%
low or moderate
yes
NA
NA
16%
high
NA
no
NA
23%
high
NA
yes
< 11
41%
high
NA
yes
>= 11
57%
where:
• Procedure risk is high if >= 20% of patients experience a postoperative physiologic decline.
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