新得出的术前 POSSUM 评分是预测开罗大学医院麻醉师下令将外科手术患者分配到选择性术后重症监护室的一个指标

H. Ahmed, D. Soliman, A. Raouf, M. Elshazly, Verina Youhana, Ahmed Nabih
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引用次数: 0

摘要

背景麻醉医生在择期手术后申请术后重症监护病房床位时会考虑多种因素。这一决定可能基于手术风险和合并症。有些手术可能会推迟,有些病人可能会不必要地住进重症监护室。因此,麻醉科医生需要根据一定的评分来决定是否将患者送入重症监护室。目的 评估用于计算死亡率和发病率的术前生理和手术严重程度评分(POSSUM)作为术后是否需要入住 ICU 的预测指标的准确性。患者和方法 本研究计算了在埃及开罗领先的三级医院卡斯尔阿莱尼医院(Kasr Alainy Hospital)接受择期普通外科手术的 308 名患者的术前 POSSUM 评分(术前 POSSUM)。结果 我们的研究表明,POSSUM 术前评分的临界值可以预测哪些患者最受益于术后入住重症监护室。估计发病率的最佳临界值为 19.545,灵敏度为 100%,特异度为 64.3%。此外,估计死亡率的临界值为 3.375,灵敏度为 100%,特异度为 62%。结论 预POSSUM可作为一种可靠的工具,用于对择期普外科手术后的患者进行分配,确定哪些患者需要加强术后护理,并利用研究中显示的临界值帮助对择期手术后的患者进行分流。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The novel derived preoperative-POSSUM score as a predictor of surgical patients’ allocation to an elective postoperative ICU ordered by anesthesiologists at Cairo University Hospital
Backgroun d Anesthesiologists depend on multiple factors to request a postoperative ICU bed after elective surgeries. This decision may be based on the risk of surgery and comorbidities. Some surgeries may be postponed, or some patients may be exposed to unnecessary ICU admission. So, this aroused the need for certain scores upon which anesthesiologist could build their request for ICU admission. Aim To evaluate the accuracy of the pre-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) score as a predictor for the need for postoperative ICU. Patients and methods This study calculated the POSSUM score preoperatively (pre-POSSUM) for 308 patients who underwent elective general surgeries at Kasr Alainy Hospital, a leading tertiary care hospital in Cairo, Egypt. Results Our study showed the possibility of having a cutoff value of pre-POSSUM score that could predict patients who would benefit most from a postoperative ICU stay. The best cutoff value for the estimated morbidity percent was 19.545, with 100% sensitivity and 64.3% specificity. Moreover, the estimated mortality percent at a cutoff value of 3.375 showed 100% sensitivity and 62% specificity. Conclusion The pre-POSSUM could be used as a reliable tool for the allocation of patients after elective general surgeries, identify those who require intensive postoperative care, and use the cutoff values shown in a study to help to triage patients after elective surgeries.
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