Margenthaler et al evaluated adults after appendectomy for risk factors associated with 30-day morbidity. This can help identify patients who may benefit from more aggressive monitoring and management. The authors are from St Louis University, Harvard Medical School, and the Veterans Administration.
Parameters:
(1) ASA class
(2) weight loss in 6 months prior to surgery
(3) functional health status
(4) wound status
(5) history of COPD (chronic obstructive pulmonary disease)
(6) preoperative serum bilirubin
(7) age in decades
(8) operative time in hours
(9) preoperative WBC cell count in thousands
(10) preoperative BUN in mg/dL
(11) preoperative albumin
|
Parameter |
Finding |
Points |
|
ASA class |
I or II |
0 |
|
|
III |
0.2529 |
|
|
IV or V |
0.9288 |
|
weight loss |
> 10% |
0.8127 |
|
|
<= 10% |
0 |
|
health status |
independent |
0 |
|
|
partially dependent |
0.5423 |
|
|
totally dependent |
0 |
|
surgical wound status |
clean |
0 |
|
|
clean-contaminated |
0 |
|
|
contaminated or infected |
0.3721 |
|
history of COPD |
none |
0 |
|
|
present |
0.3712 |
|
Parameter |
Points |
|
preoperative bilirubin in mg/dL |
0.1693 * (bilirubin) |
|
age in years |
(age) / 10 * 0.1588 |
|
hours of operative time |
(hours) * 0.0675 |
|
preoperative WBC count per µL |
(WBC) / 1000 * 0.0256 |
|
preoperative BUN in mg/dL |
(BUN) * 0.0181 |
|
preoperative albumin in g/dL |
(albumin) * (-0.2097) |
where:
• Age decade could either be (age)/10, INT((age/10)) or ROUND((age)/10,0). I will use the INT version in the spreadsheet.
• The age of patients ranged from 17 to 104 years.
X =
= SUM(points for all of the parameters) - 2.5724
probability of 30-day morbidity =
= 1 / (1 + EXP((-1) * X)
Specialty: Gastroenterology, Pedatrics, Surgery, general
ICD-10: ,
