Document Detail


The development of a postoperative morbidity score to assess total morbidity burden after cardiac surgery.
MedLine Citation:
PMID:  22360990     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Julie Sanders; Bruce E Keogh; Jan Van der Meulen; John P Browne; Tom Treasure; Michael G Mythen; Hugh E Montgomery
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical epidemiology     Volume:  65     ISSN:  1878-5921     ISO Abbreviation:  J Clin Epidemiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-02-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801383     Medline TA:  J Clin Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  423-33     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Institute for Human Health and Performance, University College London, London N19 5LW, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Development of a patient-reported outcome measure for the foot affected by rheumatoid arthritis.
Next Document:  The "Spirit 8" successfully captured spiritual well-being in African palliative care: factor and Ras...