The development of a postoperative morbidity score to assess total morbidity burden after cardiac surgery
The development of a postoperative morbidity score to assess total morbidity burden after cardiac surgery
复制标题
DOI：
10.1016/j.jclinepi.2011.11.004
复制
发表时间：
2012-04-01
影响因子：
7.2
通讯作者：
Montgomery, Hugh E.
中科院分区：
文献类型：
--
作者：
Sanders, Julie;Keogh, Bruce E.;Montgomery, Hugh E.
目的：开发一种识别和量化心脏手术后发病率的工具（心脏术后发病率评分 [C-POMS]）。 研究设计和设置：使用 POMS 标准（普外科患者的 9 个术后发病率领域）和心脏特异性变量（来自专家小组），对 450 名心脏手术患者术后第 1、3、5、8 和 15 天的发病率进行了前瞻性评估。其他发病率以自由文本形式注明，如果患病率超过 5%，缺失率低于 5%，且专家评定的平均严重性-重要性指数得分超过 8，则包括在内。构建有效性由专家小组审查进行评估。 Cronbach's alpha（内部一致性）和线性回归（C-POMS 对住院时间 [LOS] 的预测能力）。结果：导出了 13 域模型。 D3-D15 的内部一致性 (>0.7) 允许用作总发病率负担的总分。平均 C-POMS 评分为 3.4 (D3)、2.6 (D5)、3.4 (D8) 和 3.8 (D15)。与没有 C-POMS 定义的 D3、D5、D8 和 D15 发病率的患者相比，患者 LOS 分别长 4.6 天（P = 0.012）、5.3 天（P = 0.001）和 7.6 天（P = 0.135）。 C-POMS 总分每增加一个单位，随后的 LOS 就会增加 1.7 (D3)、2.2 (D5)、4.5 (D8) 和 6.2 (D15) 天（所有 P = 0.000）。结论：C-POMS 是第一个经过验证的用于确定心脏手术后总发病率负担的工具。然而，需要进一步的外部验证。 (C) 2012 Elsevier Inc. 保留所有权利。
Objective: To develop a tool for identifying and quantifying morbidity following cardiac surgery (cardiac postoperative morbidity score [C-POMS]).Study Design and Setting: Morbidity was prospectively assessed in 450 cardiac surgery patients on postoperative days 1, 3, 5, 8, and 15 using POMS criteria (nine postoperative morbidity domains in general surgical patients) and cardiac-specific variables (from expert panel). Other morbidities were noted as free text and included if prevalence was more than 5%, missingness less than 5%, and mean expert-rated severity-importance index score more than 8. Construct validity was assessed by expert panel review. Cronbach's alpha (internal consistency), and linear regression (predictive ability of C-POMS for length of stay [LOS]).Results: A 13-domain model was derived. Internal consistency (>0.7) on D3-D15 permits use as a summative score of total morbidity burden. Mean C-POMS scores were 3.4 (D3), 2.6 (D5), 3.4 (D8), and 3.8 (D15). Patient LOS was 4.6 days (P = 0.012), 5.3 days (P = 0.001), and 7.6 days (P = 0.135) longer in patients with C-POMS-defined morbidity on D3, D5, D8, and D15, respectively, than in those without. For every unit increase in C-POMS summary score, subsequent LOS increased by 1.7 (D3), 2.2 (D5), 4.5 (D8), and 6.2 (D15) days (all P = 0.000).Conclusion: C-POMS is the first validated tool for identifying total morbidity burden after cardiac surgery. However, further external validation is warranted. (C) 2012 Elsevier Inc. All rights reserved.