Cham et al reported a model for predicting the risk of adverse perioperative outcomes for a woman undergoing surgery for ovarian cancer. The authors are from Columbia University, New York Presbyterian Hospital and Massachusetts General Hospital.
Patient selection: surgery for ovarian cancer
Outcome: Clavien-Dindo IV complications or mortality
Parameters:
(1) ASA
(2) serum albumin in g/dL
(3) bleeding disorder
(4) ascites
(5) elective surgery
(6) age in years
(7) procedure score
Procedure score - 1 point for each of the following:
(1) lymph node dissection
(2) small bowel resection
(3) colon resection
(4) rectosigmoid resection
(5) liver resection
(6) bladder resection
(7) diaphragm resection
(8) debulking
|
Parameters
|
Findings
|
Points
|
|
ASA
|
ASA 1
|
0
|
|
|
ASA 2
|
17
|
|
|
ASA 3
|
30.7
|
|
|
ASA 4 or 5
|
70
|
|
albumin
|
> 4.0 g/dL
|
0
|
|
|
3.5 to 4.0
|
22.8
|
|
|
< 3.5 g/dL
|
44
|
|
bleeding disorder
|
no
|
0
|
|
|
yes
|
66
|
|
ascites
|
no
|
0
|
|
|
yes
|
30
|
|
elective surgery
|
no
|
36
|
|
|
yes
|
0
|
|
age
|
< 50 years
|
18
|
|
|
50 to 59 years
|
0
|
|
|
60 to 69 years
|
21.8
|
|
|
70 to 79 years
|
38.6
|
|
|
>= 80 years
|
60
|
|
procedure score
|
0
|
0
|
|
|
1
|
22.8
|
|
|
2
|
53.8
|
|
|
>= 3
|
100
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 406
probability of adverse outcome for score 0 to 250 =
= (0.000000016759 * ((score)^3)) - (0.0000001984 * ((score)^2)) + (0.00021028 * (score)) + 0.010605
probability of adverse outcome for score 250 to 406 =
= (-0.000003888 * ((score)^2)) + (0.0058937 * (score)) - 0.92012
