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Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review

Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review
Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review
Risk stratification is essential for both clinical risk prediction and comparative audit. There are a variety of risk stratification tools available for use in major noncardiac surgery, but their discrimination and calibration have not previously been systematically reviewed in heterogeneous patient cohorts.Embase, MEDLINE, and Web of Science were searched for studies published between January 1, 1980 and August 6, 2011 in adult patients undergoing major noncardiac, nonneurological surgery. Twenty-seven studies evaluating 34 risk stratification tools were identified which met inclusion criteria. The Portsmouth-Physiology and Operative Severity Score for the enUmeration of Mortality and the Surgical Risk Scale were demonstrated to be the most consistently accurate tools that have been validated in multiple studies; however, both have limitations. Future work should focus on further evaluation of these and other parsimonious risk predictors, including validation in international cohorts. There is also a need for studies examining the impact that the use of these tools has on clinical decision making and patient outcome.
0003-3022
959-981
Moonesinghe, Suneetha Ramani
4deeef03-dc8e-46b5-b019-adc7410e05df
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Das, Priya
9af1a461-77f3-4adc-87a6-cb5980852d68
Rowan, Kathryn M.
cfa2982f-ac08-4e89-81c1-f45fd8244760
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Moonesinghe, Suneetha Ramani
4deeef03-dc8e-46b5-b019-adc7410e05df
Mythen, Michael G.
940f5be7-e5bc-4a90-94aa-09fdc658caad
Das, Priya
9af1a461-77f3-4adc-87a6-cb5980852d68
Rowan, Kathryn M.
cfa2982f-ac08-4e89-81c1-f45fd8244760
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2

Moonesinghe, Suneetha Ramani, Mythen, Michael G., Das, Priya, Rowan, Kathryn M. and Grocott, Michael P.W. (2013) Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review. Anesthesiology, 119 (4), 959-981. (doi:10.1097/ALN.0b013e3182a4e94d). (PMID:24195875)

Record type: Article

Abstract

Risk stratification is essential for both clinical risk prediction and comparative audit. There are a variety of risk stratification tools available for use in major noncardiac surgery, but their discrimination and calibration have not previously been systematically reviewed in heterogeneous patient cohorts.Embase, MEDLINE, and Web of Science were searched for studies published between January 1, 1980 and August 6, 2011 in adult patients undergoing major noncardiac, nonneurological surgery. Twenty-seven studies evaluating 34 risk stratification tools were identified which met inclusion criteria. The Portsmouth-Physiology and Operative Severity Score for the enUmeration of Mortality and the Surgical Risk Scale were demonstrated to be the most consistently accurate tools that have been validated in multiple studies; however, both have limitations. Future work should focus on further evaluation of these and other parsimonious risk predictors, including validation in international cohorts. There is also a need for studies examining the impact that the use of these tools has on clinical decision making and patient outcome.

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More information

Published date: October 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 360531
URI: http://eprints.soton.ac.uk/id/eprint/360531
ISSN: 0003-3022
PURE UUID: 5b7c16a5-88b4-4af4-959d-4470b282d016
ORCID for Michael P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 16 Dec 2013 11:04
Last modified: 28 Apr 2022 02:01

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Contributors

Author: Suneetha Ramani Moonesinghe
Author: Michael G. Mythen
Author: Priya Das
Author: Kathryn M. Rowan

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