Cohen et al reported odds ratios (OR) for morbidity and mortality for patients undergoing colorectal surgery based on the American College of Surgeons (ACS) National Surgical Quality Improvement (NSQI) Program. This was used to develop a model for predicting overall morbidity, severe morbidity and mortality.
Parameters:
(1) ASA classification
(2) sepsis-related
(3) impairment in functional status
(4) serum albumin
(5) reason for surgery
(6) disseminated cancer
(7) extent of colorectal resection
(8) body mass index (BMI)
(9) emergency surgery
(10) age in years
(11) dyspnea at rest
(12) serum creatinine
(13) COPD
(14) surgical wound class
(15) aPTT
|
Parameter |
Finding |
OR Overall Morbidity |
OR Mortality |
|
ASA |
ASA 3 |
1.5 |
2.3 |
|
|
ASA 4 or 5 |
2 |
4.8 |
|
sepsis-related |
SIRS |
1.5 |
1.5 |
|
|
sepsis |
1.3 |
1.6 |
|
|
septic shock |
1 |
2.1 |
|
impairment |
partial |
1.4 |
2 |
|
|
total |
1.5 |
2.8 |
|
serum albumin |
<= 3.5 g/dL |
1.3 |
2 |
|
reason for surgery |
enteritis or colitis |
1.2 |
0.8 |
|
|
obstruction or perforation |
1.5 |
1.4 |
|
|
vascular insufficiency |
1.1 |
1.8 |
|
|
volvulus |
1.2 |
1.6 |
|
disseminated cancer |
|
1.3 |
3.3 |
|
extent |
partial colectomy |
0.7 |
5.3 |
|
|
proctectomy |
1 |
2.3 |
|
|
total procto-colectomy |
1 |
2.9 |
|
|
total colectomy |
0.9 |
5.9 |
|
weight |
obese Class 1 or 2 |
1.3 |
0.9 |
|
|
obese Class 3 |
1.9 |
0.8 |
|
|
overweight |
1.2 |
0.8 |
|
|
underweight |
1 |
1.5 |
|
emergency |
|
1.2 |
1.5 |
|
age |
65 to 74 |
1.1 |
1.7 |
|
|
75 to 84 |
1.2 |
2.7 |
|
|
85+ |
1.1 |
4.1 |
|
dyspnea at rest |
|
1.3 |
1.7 |
|
serum creatinine |
> 1.2 mg/dL |
1.1 |
1.7 |
|
COPD |
|
1.4 |
1.4 |
|
wound class |
not clean or clean contaminated |
1.3 |
1.2 |
|
aPTT |
> 35 seconds |
1 |
1.1 |
cumulative odds ratio =
= PRODUCT(odds ratio for the 15 parameters)
Specialty: Anesthesiology
ICD-10: ,
