Margenthaler et al reported risk scores for complications following surgery for small bowel obstruction (SBO). One score predicts 30-day risk of mortality. The authors are from Washington University, Yale University, St. Louis VA Medical Center, University of Colorado, Denver VA Medical Center, Harvard University and Brockton West Roxbury VA Medical Center.
Patient selection: surgery for small bowel obstruction (SBO)
Parameters:
(1) history of disseminated cancer
(2) ASA class
(3) preoperative hematocrit in percent
(4) preoperative sodium in mmol/L
(5) preoperative serum creatinine in mg/dL
(6) wound classification
(7) dyspnea
(8) age in decades
Parameter
Finding
Points
disseminated cancer
no
0
yes
8
ASA class
1 or 2
0
3
8
4 or 5
15
preoperative hematocrit
>= 38%
0
< 38%
7
preoperative sodium
<= 145 mmol/L
0
> 145 mmol/L
7
serum creatinine
<= 1.2 mg/dL
0
> 1.2 mg/dL
8
wound classification
clean
0
clean contaminated
2
dirty
10
infected
17
dyspnea
with minimum exertion
1
at rest
11
other
0
age
< 50 years
0
50 to 59 years
4
60 to 69 years
2
70 to 79 years
6
>= 80 years
13
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 86
• The higher the score the greater the risk of mortality.
Total Score
Class
30-Day Mortality
0 to 12
1
2%
12 to 18
2
3%
18 to 23
3
4%
23 to 31
4
9%
>= 31
5
28%
where:
• There is overlap in the scores defining the various risk classes.
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