Weinberg et al developed a number of scores for identifying pediatric patients at risk for complications associated with surgery. These can help to identify a patient who may benefit from more aggressive management or a nonoperative therapy. The authors are from Children's Hospital Boston.
Patient selection: pediatric patient undergoing surgery
Parameters:
(1) gestational age (if neonate)
(2) ASA class
(3) cardiovascular surgery performed
(4) neurosurgery performed
(5) albumin infusion
(6) orthopedic surgery
(7) history of cardiovascular disease
(8) operation duration
(9) transfusion of packed RBCs
(10) oxygen saturation in percent
|
Parameter |
Finding |
Points |
|---|---|---|
|
gestational age |
<= 36 weeks |
4 |
|
|
other |
0 |
|
ASA class |
1, 2 or 3 |
0 |
|
|
4 or 5 |
5 |
|
cardiovascular surgery |
no |
0 |
|
|
yes |
3 |
|
neurosurgery |
no |
0 |
|
|
yes |
4 |
|
albumin infusion |
no |
0 |
|
|
yes |
5 |
score for overall complications =
= SUM(points for all 5 parameters)
|
Parameter |
Finding |
Points |
|---|---|---|
|
gestational age |
<= 36 weeks |
4 |
|
|
other |
0 |
|
ASA class |
1, 2 or 3 |
0 |
|
|
4 or 5 |
5 |
|
cardiovascular surgery |
no |
0 |
|
|
yes |
4 |
|
neurosurgery |
no |
0 |
|
|
yes |
5 |
|
orthopedic surgery |
no |
0 |
|
|
yes |
2 |
|
history of cardiovascular disease |
no |
0 |
|
|
yes |
2 |
score for complications using preoperative factors =
= SUM(points for all 6 parameters)
|
Parameter |
Finding |
Points |
|---|---|---|
|
operation duration |
<= 2 hours |
0 |
|
|
> 2 hours |
3 |
|
packed RBC transfusion |
no |
0 |
|
|
yes |
3 |
|
oxygen saturation |
> 96% |
0 |
|
|
<= 96% |
4 |
|
albumin infusion |
no |
0 |
|
|
yes |
4 |
score for complications using operative factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum scores: 0
• maximum overall score: 21
• maximum preoperative score: 22
• maximum operative score: 14
• The higher the scores the greater the risk for major complications.
|
Total Overall Score |
Number of Parameters |
Odds Ratio Complications |
|---|---|---|
|
0 |
0 |
|
|
1 to 5 |
1 |
19 |
|
6 or more |
2 or more |
387 |
Purpose: To identify a pediatric patient undergoing surgery who is at risk for complications using scores from Childrens Hospital Boston.
Specialty: Anesthesiology
Objective: risk factors, severity, prognosis, stage, complications, complication detection, comorbid conditions, surgery
ICD-10: T88.8, T88.9,
