Kuo et al developed models for predicting death in moribund patients undergoing general surgery. These can help to advise family members on the risks faced by the patients. The authors are from the University of Pennsylvania.
Patient selection: moribund general surgical being operated on during the first 24 hours after admission >= 20 years of age
Types of surgery: chest wall/thoracotomy, vascular, abdominopelvic, skin/soft tissue
Outcome: death
Parameters:
(1) age in years
(2) functional status
(3) dialysis within past 30 days
(4) myocardial infarction (AMI) within past 6 months
(5) ventilator dependency
Parameter
Findings
Points
age in years
20 to 59 years
0
60 to 79 years
2
>= 80 years
3
functional status
fully dependent
2
partially or fully independent
0
dialysis
no
0
yes
1
AMI
no
0
yes
1
ventilator dependent
no
0
yes
2
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the risk of mortality.
Score
Mortality
0 or 1
23-29%
2
35-41%
3
44-45%
4
47-55%
5
55-62%
6
54-62%
7
58-72%
8 or 9
76-78%
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