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


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), pp. 959-981. (doi:10.1097/ALN.0b013e3182a4e94d). (PMID:24195875).

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Description/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.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1097/ALN.0b013e3182a4e94d
ISSNs: 0003-3022 (print)
Subjects: R Medicine > RD Surgery
Organisations: Human Development & Health
ePrint ID: 360531
Date :
Date Event
October 2013Published
Date Deposited: 16 Dec 2013 11:04
Last Modified: 20 Feb 2017 19:58
Further Information:Google Scholar
URI: http://eprints.soton.ac.uk/id/eprint/360531

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