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Nomogram of Dalton et al for Predicting 30-Day Postoperative Morbidity Following Noncardiac Surgery

Purpose: To predict 30-day morbidity following noncardiac surgery using the nomogram of Dalton et al.

Description

Dalton et al reported 2 nomograms for predicting 30 day morbidity and mortality following noncardiac surgery. The model for morbidity can help to identify a patient at risk for a major nonfatal complication. The authors are from the Cleveland Clinic and McMaster University.


Each CPT code was assigned a Proceedural Severity Score (PSS), which is a univariable score measuring procedure-associated risks.

 

Patient selection: noncardiac surgery and age from 10 to 90 years

 

Parameters:

(1) Procedural Severity Score for the surgical CPT (available at links.lww.com/ALN/A738

(2) ASA physical status

(3) hospitalization (inpatient vs outpatient)

 

Parameter

Finding

Points

ASA physical status

ASA 1

0

 

ASA 2

7.3

 

ASA 3

22

 

ASA 4

43

 

ASA 5

75

hospitalization

outpatient

0

 

inpatient

26

 

total score =

= (points for PSS) + (points for ASA status) + (points for hospitalization)

 

Total Score

30-Day Major Morbidity

< 50

< 1%

50 to 113

(0.000066 * ((points)^3)) - (0.01028 * ((points)^2)) + (0.6069 * (points)) - 11.85

113 to 168

(1.122 * (points)) - 107.3

168 to 218

(-0.006645 * ((points)^2)) + (2.912 * (points)) - 221.3

 


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Specialty

Objective

ICD-10