A Review of Risk Scoring Systems Utilised in Patients Undergoing Gastrointestinal Surgery

Chandra, Aninda; Mangam, Sudhakar; Marzouk, Diaa

doi:10.1007/s11605-009-0857-z

Cited by 60 publications

(44 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the control groups also had an equivalent percentage of ASA 3 because ASA classification was one of the matching criteria used in our study. It is therefore possible that ASA classification could be inaccurate in evaluating the influence of comorbidities on long-term outcomes [19]. In particular, different types and degrees of comorbidity may have been included within the same ASA classification, which may have disproportionately affected the mortality rate in the CONV group.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes

et al. 2012

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Many authors have demonstrated the predictive value of the APACHE II system in both general and emergency surgical patients. [19][20][21][22] The APACHE II system, however, is rather cumbersome, requiring a considerable number of investigations and patient history, some of which would not be immediately available in the emergency setting. In addition, the APACHE II system fails to take into account operative findings.…”

Section: Discussionmentioning

confidence: 99%

Decisions to operate: the ASA grade 5 dilemma

Horwood

Ratnam

Maw

2011

annals

View full text Add to dashboard Cite

INTRODUCTION Deciding to operate on high risk patients suffering catastrophic surgical emergencies can be problematic. Patients are frequently classed as American Society of Anesthesiologists (ASA) grade 5 and, as a result, aggressive but potentially lifesaving intervention is withheld. The aim of our study was to review the short-term outcomes in patients who were classed as ASA grade 5 but subsequently underwent surgery despite this and to compare the ASA scoring model to other predictors of surgical outcome. METHODS All patients undergoing emergency surgery with an ASA grade of 5 were identified. Patient demographics, indications for surgery, intraoperative findings and outcomes were recorded. In addition to the ASA scores, retrospective Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P POSSUM) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated and compared to the observed outcomes. RESULTS Nine patients (39%) survived to discharge. ASA grade was a poor predictor of outcome. P POSSUM and APACHE II scores correlated significantly with each other and with observed outcomes when predicting surgical mortality. The median stay for survivors in the intensive care unit was nine days. CONCLUSIONS In times of an ageing population, the number of patients suffering catastrophic surgical events will increase. Intervention, with little hope of a cure, a return to independent living or an acceptable quality of life, leads to unnecessary end-of-life suffering for patients and their relatives, and consumes sparse resources. The accuracy and reliability of ASA grade 5 as an outcome predictor has been questioned. P POSSUM and APACHE II scoring systems are significantly better predictors of outcome and should be used more frequently to aid surgical decision-making in high risk patients.

show abstract

“…La evaluación de los riesgos potenciales de morbilidad y mortalidad perioperatoria con puntuaciones específicamente diseñadas para ello, es importante en la práctica clínica 25 . Estas puntuaciones intentan cuantificar el riesgo de morbilidad y mortalidad del paciente 25,26 .…”

Section: Discussionunclassified

“…Estas puntuaciones intentan cuantificar el riesgo de morbilidad y mortalidad del paciente 25,26 . Se han descrito tres tipos de puntuaciones pronósticas para pacientes quirúrgicos 27 ; puntaciones generales como P-POSSUM, puntuaciones específicas para morbilidad asociada como el índice cardiológico de Goodman y puntuaciones específicas para patología quirúrgica como P-Boey.…”

Section: Discussionunclassified

“…Se han descrito tres tipos de puntuaciones pronósticas para pacientes quirúrgicos 27 ; puntaciones generales como P-POSSUM, puntuaciones específicas para morbilidad asociada como el índice cardiológico de Goodman y puntuaciones específicas para patología quirúrgica como P-Boey. Mediante el uso de puntuaciones pronósticas en pacientes sometidos a cirugía de urgencia, el cirujano tendría el respaldo para comunicar el riesgo asociado a los pacientes y familiares, además de solicitar el manejo postoperatorio en la Unidad de Paciente Crítico o en casos extremos declinar la cirugía en pacientes moribundos 25 . Los factores de riesgo asociados a morbilidad y mortalidad postoperatoria en pacientes con UPP han sido extensamente estudiadas [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] .…”

Section: Discussionunclassified

See 1 more Smart Citation

Utilidad De La Puntuación De Boey Y Portsmouth-Possum Fisiológico en Pacientes Con Úlcera Péptica Perforada

J²,

Valenzuela

et al. 2014

Rev Chil Cir

View full text Add to dashboard Cite

A Review of Risk Scoring Systems Utilised in Patients Undergoing Gastrointestinal Surgery

Cited by 60 publications

References 54 publications

Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes

Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes

Decisions to operate: the ASA grade 5 dilemma

Utilidad De La Puntuación De Boey Y Portsmouth-Possum Fisiológico en Pacientes Con Úlcera Péptica Perforada

Contact Info

Product

Resources

About