围术期风险预测评分 - WFSA - Resources

1 Subscribe to ATOTW tutorials by visiting ATOTW 343 Perioperative risk prediction scores (13th Dec 2016) Page 1 of 6 I N T E N S I V E C A R E Tutorial 343 Dr. Maria Chereshneva and Dr. Ximena Watson Anaesthetic Registrars, Croydon University Hospital, UK Dr. Mark Hamilton Anaesthetic Consultant, St Georges Hospital, UK Edited by Dr. Harjot Singh Correspondence to NELA 2015 6 1 2 1.

2 A. b. c. d. e. 2. a. APACHE b. V-POSSUM c. Child-Turcotte-Pugh d. e. 3. a. ASA b. 7 c. d. e. 13th Dec 2016 Subscribe to ATOTW tutorials by visiting ATOTW 343 Perioperative risk prediction scores (13th Dec 2016)

3 Page 2 of 6 <1% >5% 1 <1% <5% >5% 1. NELA Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity POSSUM P -POSSUM 3 P-POSSUM Surgical Outcome Risk Tool SORT 4 National Surgical Quality Improvement Program ACS NSQIP 5 ICU Acute Physiology and Chronic Health Evaluation APACHEII 6 APACHE 2 European System for Cardiac Operative Risk Evaluation EuroSCORE 7 CABG

4 17 EuroSCORE logistic 8 2011 EuroSCORE II 9 EuroSCORE II 18 The Society of Thoracic Surgeons mortality risk score STS 10 STS 40 EuroScore STS EuroScore APACHE II 24 h 12 24 h POSSUM 12 6 SORT 6 Subscribe to ATOTW tutorials by visiting ATOTW 343 Perioperative risk prediction scores (13th Dec 2016) Page 3 of 6 ASA ACS NSQIP Surgical Risk Calculator 21 2.

5 EuroScore STS / CABG Ambler11 32000 V-POSSUM V-POSSUM V-POSSUM ASA 1941 ASA 12 ASA 13 14 ASA 15 6 3 I IV 4 16 5 16 Arozullah 17,18 NSQUIP the department of Veterans AffairsNSQUIP logistic > mol/L 3.

6 27 14 21 11 I 0 II 1 III 2 IV 3 3 11% Subscribe to ATOTW tutorials by visiting ATOTW 343 Perioperative risk prediction scores (13th Dec 2016) Page 4 of 6 11 < mg dL 1 9 >30 mg dL 1 8 7 COPD 6 70 6 60 69 4 Figure 4. 5. 7 15000 19 >59 BMI >32 COPD 6 20 6 >56 6.

7 20 70 Child-Turcotte-Pugh (CTP) INR CTP Child A 10% B 30% C 76-82%21 MELD INR CTP MELD MELD 22 MELD CTP % 1 10 211 320 428 5 40 15 14 10 08 03 80 17 70 79 13 60 69 09 50 59 04 10 6 6 10% 7 COPD 5 4 4 4 mg dL 1 <8 4 22 30 2 30 3 4 3 3 3 3 >2 doses 2

8 I 0-2 II 3 III 4 IV 5 V 6+ Subscribe to ATOTW tutorials by visiting ATOTW 343 Perioperative risk prediction scores (13th Dec 2016) Page 5 of 6 Cardiopulmonary exercise CPEX 23 ANSWERS TO QUESTIONS 1. a.

9 : NCEPOD knowing the risk 37/496 b. : c. d. e. : 2. a. : APACHE b. : c. : MELD CTP : d. : CPEX e. : Ambler 3. a. b. : 7 >59 BMI>32 , COPD c. : d. : e. Dr. Steve Copplestone S ATOTW 343 REFEREN 1. NELA p2. Wong PrythercPhysiolo85:12174.

10 Protopa(SORT)5. Bilimoridecision6. Goffi L, operatio7. Nashef risk eva8. Roques9. Nashef 10. Anderso57: 6-7 11. Ambler heart va12. Saklad 13. Wolterspostope14. Woltersmultivar15. Lee THpredictio16. SmetansurgeryAnn Inte17. Khuri Ssurgery253 18. Arozullapredicti19. Kheterpsurgery20. Kheterppatients21. Friedma22. O'LearyGastroe23. Carlisleexercise24. Epsteinday out Subscribe to AT Perioperative rNCES ANDproject team. FDT, Knaus WA. Can J Anaesch DR, Whitelogical and Op7-1220 apa KL, Simps). Br J Surg 20a KY, Liu Y, Pn aid and InforSaba V, Ghisons: prognostiSA, Roques Faluation (EuroSs F, Michel P, SA, Roques Fon RP.