Story et al developed a Perioperative Mortality Risk Score for evaluating older adults undergoing surgery. The authors are from the Trials Group and Perioperative Medicine Committee, Australian and New Zealand College of Anaesthetists in Melbourne.
Patient selection: patient >= 70 years of age undergoing surgery
Outcome: 30-day mortality
Preoperative risk factors:
(1) age in years
(2) ASA classification
(3) serum albumin
Postoperative risk factors:
(4) unplanned ICU admission
(5) systemic inflammatory response (SIR)
(6) acute renal impairment
|
Parameter |
Finding |
Points |
|
age in years |
70 to 79 years of age |
1 |
|
|
80 to 89 years of age |
3 |
|
|
>= 90 years of age |
6 |
|
ASA classification |
ASA 1 or 2 |
0 |
|
|
ASA 3 |
3 |
|
|
ASA 4 |
6 |
|
|
ASA 5 |
15 |
|
preoperative serum albumin |
>= 3 g/dL |
0 |
|
|
< 3 g/dL |
2.5 |
|
unplanned ICU admission |
no |
0 |
|
|
yes |
4 |
|
SIR |
no |
0 |
|
|
yes |
3 |
|
acute renal impairment |
no |
0 |
|
|
yes |
2.5 |
total score =
= SUM(points for all 6 risk factors)
Interpretation:
• minimum score: 0
• maximum score: 33
• The higher the score the greater the risk of mortality.
• Results can be used in conjunction with surgical complexity and urgency to improve the prediction.
|
Total Score |
Mortality |
|
1 to 4.5 |
1% (low) |
|
5 to 9.5 |
7% (moderate) |
|
>= 10% |
26% (high) |
Purpose: To estimate the 30-day risk of mortality for an older adult who has undergone surgery using the Perioperative Mortality Risk Score.
Specialty: Anesthesiology
Objective: severity, prognosis, stage, complications, complication detection, surgery
ICD-10: ,
