Burke et al reported a simple score for predicting severe complications after non-elective cholecystectomy. The authors are from Columbia University and the University of Miami.
Patient selection: >= 18 years of age, non-elective cholecystectomy (urgent or emergent)
Outcome: 30-day severe complications (Clavien-Dindo Grade IV or V)
Parameters:
(1) age in years
(2) sepsis
(3) planned open procedure
(4) eGFR in mL per min per 1.73 square meter
(5) serum albumin in g/dL
|
Parameter |
Finding |
Points |
|
age |
18 to 30 years |
0 |
|
|
31 to 40 years |
2 |
|
|
41 to 50 years |
4 |
|
|
51 to 60 years |
6 |
|
|
61 to 70 years |
8 |
|
|
71 to 80 years |
10 |
|
|
> 80 years |
12 |
|
sepsis |
no |
0 |
|
|
yes |
5 |
|
planned open procedure |
no |
0 |
|
|
yes |
5 |
|
eGFR |
>= 90 |
0 |
|
|
60 to 89.9 |
3 |
|
|
30 to 59.9 |
7 |
|
|
< 30 |
13 |
|
serum albumiin |
< 2.5 g/dL |
8 |
|
|
2.5 to 3.1 g/dL |
4 |
|
|
3.11 to 3.7 g/dL |
2 |
|
|
> 3.7 g/dL |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 43
• The higher the score the greater the risk of severe complications.
|
Score |
Risk |
|
0 |
0.1% |
|
1 to 3 |
0.2% |
|
4 or 5 |
0.3% |
|
6 or 7 |
0.4% |
|
8 |
0.5% |
|
9 |
0.6% |
|
10 |
0.7% |
|
11 |
0.8% |
|
12 |
1% |
|
13 |
1.1% |
|
14 |
1.3% |
|
15 |
1.6% |
|
16 |
1.8% |
|
17 |
2.1% |
|
18 |
2.5% |
|
19 |
2.9% |
|
20 |
3.4% |
|
21 |
4% |
|
22 |
4.7% |
|
23 |
5.5% |
|
24 |
6.4% |
|
25 |
7.4% |
|
26 |
8.6% |
|
27 |
10% |
|
28 |
12% |
|
29 |
13% |
|
30 |
15% |
|
31 |
17% |
|
32 |
20% |
|
33 |
23% |
|
34 |
26% |
|
35 |
29% |
|
36 |
32% |
|
37 |
36% |
|
38 |
40% |
|
39 |
43% |
|
40 |
47% |
|
41 |
51% |
|
42 |
55% |
|
43 |
59% |
Performance:
• The area under the ROC curve is 0.85 in the derivation and 0.87 in the validation cohorts.
Specialty: Gastroenterology
