Huang et al developed a score for predicting prolonged ileus following radical gastrectomy for gastric cancer. This can identify a patient who may benefit from more aggressive management. The authors are from the First Affiliated Hospital of Wenzhou Medical University and Shanghai Tenth People's Hospital of Tongji University.
Patient selection: gastric cancer treated with radical gastrectomy, ASA class <= 3, TNM stage <= III (not Stage IV)
Outcome: prolonged postoperative ileus
Parameter:
(1) age in years
(2) duration of operation in hours
(3) procedure (open, conversion, laparoscopic)
(4) TNM Stage
(5) postoperative opiate dose in mg per kg body weight
|
Parameter |
Finding |
Points |
|
age in years |
< 65 years |
0 |
|
|
>= 65 years |
1 |
|
duration of operation |
< 4 hours |
0 |
|
|
>= 4 hours |
1 |
|
procedure |
laparoscopic |
0 |
|
|
open or convereted |
1 |
|
TNM stage |
I or II |
0 |
|
|
III |
1 |
|
postoperative opiate dose |
< 0.3 mg/kg |
0 |
|
|
>= 0.3 mg/kg |
2 |
score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of PPOI.
|
Score |
Risk Group |
Percent PPOI |
|
0 to 2 |
low |
11% |
|
3 or 4 |
moderate |
31% |
|
5 or 6 |
high |
83% |
Performance:
• The area under the ROC curve was 0.84.
Specialty: Gastroenterology, Surgery, orthopedic, Surgery, general
