Lipton et al developed a Postoperative Complication Score (POCS) for quantitating the postoperative complications in children with cerebral palsy undergoing spinal fusion for scoliosis. This can be used to compare outcomes of different surgical approaches. The authors are from Temple University and the Alfred duPont Institute.
Parameters:
(1) blood loss
(2) pneumothorax
(3) days intubated
(4) reintubation
(5) first feeding
(6) febrile course postoperative
(7) atelectasis
(8) pleural effusion
(9) infections
(10) transfusion reaction requiring therapy
(11) constipation lasting >= 4 days
(12) postoperative seizures
(13) time in the intensive care unit (ICU)
(14) days in hospital
|
Parameter |
Finding |
Points |
|
blood loss |
|
(mL blood loss) / (70 * (body weight in kg)) |
|
pneumothorax |
absent |
0 |
|
|
present |
3 |
|
days intubated |
|
(days intubated) - 2 |
|
reintubation |
|
(days intubated) |
|
first feeding |
with hyperalimentation |
((postop day of first feed) - 4) * 0.25 |
|
|
without hyperalimentation |
((postop day of first feed) - 4) |
|
febrile course |
0 |
0 |
|
|
1 to 4 days duration |
1 |
|
|
5 to 8 days duration |
2 |
|
|
> 8 days duration |
4 |
|
atelectasis |
|
(number of episodes) / 2 |
|
pleural effusion |
|
(number of episodes) / 2 |
|
infection |
pulmonary |
4 |
|
|
urinary tract |
3 |
|
|
superficial wound |
2 |
|
|
deep wound |
10 |
|
|
septicemia |
8 |
|
transfusion reaction |
none |
0 |
|
|
not requiring therapy |
0 |
|
|
requires therapy |
3 |
|
constipation |
< 4 days |
0 |
|
|
>= 4 days |
0.5 |
|
postoperative seizures |
none |
0 |
|
|
controlled within 1 day |
0 |
|
|
not controlled within 1 day |
2.5 |
|
time in ICU |
|
((days in ICU) - 3) / 2 |
|
time in hospital |
|
((days in hospital) - 14) / 2 |
where:
• For days intubated, first feeding, days in ICU and days hospitalized, it appears as if a negative value are permitted.
• It appears as if all of the infections can be scored separately.
total POCS =
= SUM(points for all of the parameters)
Interpretation:
• The higher the score, the more severe the complications associated with a procedure.
Specialty: Surgery, orthopedic
