The development of a postoperative morbidity score to assess total morbidity burden after cardiac surgery.


Sanders, J; Keogh, BE; Van der Meulen, J; Browne, JP; Treasure, T; Mythen, MG; Montgomery, HE; (2011) The development of a postoperative morbidity score to assess total morbidity burden after cardiac surgery. Journal of clinical epidemiology, 65 (4). pp. 423-33. ISSN 0895-4356 DOI: https://doi.org/10.1016/j.jclinepi.2011.11.004

Full text not available from this repository.

Abstract

To develop a tool for identifying and quantifying morbidity following cardiac surgery (cardiac postoperative morbidity score [C-POMS]). 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]). 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). C-POMS is the first validated tool for identifying total morbidity burden after cardiac surgery. However, further external validation is warranted.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 22360990
Web of Science ID: 301033700010
URI: http://researchonline.lshtm.ac.uk/id/eprint/2869491

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
44Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item