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. a. b. c. d. e. 2. a. APACHE b.

2 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) Page 2 of 6 <1% >5% 1 <1% <5% >5% 1.

3 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 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.

4 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.

5 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. 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 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)

6 Page 5 of 6 Cardiopulmonary exercise CPEX 23 ANSWERS TO QUESTIONS 1. a. : 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.

7 : e. Dr. Steve Copplestone S ATOTW 343 REFEREN 1. NELA p2. Wong PrythercPhysiolo85:12174. 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. First pG, Omar RZ, alve surgery. CM. Grading ofs U, Wolf T, Sterative outcoms U, Wolf T, Striate analysis.

8 , Marcantonioon of cardiac na , Lawry: systematic rern Med 2006F. Multifactoriy. The Nationaah AM, Daley ng postoperatpal S, Trempey in patients wipal S, Trempes undergoing gan LS. Surgery JG, Friedmaenterology. 20e J, Swart M. Me testing. Br J SK, Freemancome after he This wothis lice TOTW tutorialsrisk prediction sD FURTHEF irst patient reA. Predicting osth 1991 38: 3ley MS, Higginperative Severson JC, Smith 014 101:1774-Paruch JL et armed consentselli R et al. Pric value and pF, Michel P, GSCORE). Eur Goldstone ARF, Sharples LDpublications froRoyston P, KCirculation 200f patients for stutzer H, Shromes. Br J Anaetutzer H, Shro Eur J Surg 19o, ER, Mangionrisk of major nrence , Coeview for the A6, 144:581 595al risk index foal Veterans AdJ, Hendersontive pneumonir KK, Englesbith previously r KK, Heung Mgeneral surgery in the patienn LS. Predicti007 132:1609 Mid-term surviJ Surg. 2007 9n RB, Khayat Aepatic transplaork is licensed unense, visit http://cs by visiting wwcores (13th DecER READI eport of the Naoutcome in crit374 83 ns B et al.

9 POrity Score for tNCE, et al. D-1783 al Development tool for Patienreoperative APpotential clinicaGauducheau EJ CardiothoraR, Nashef SA. D, et al. EuroSom the SocietKinsman R, Ke05 112: 224-3surgical procedder T. ASA claesth 1996 77:2der T, Pichlma997 163:563-5ne CM et al. Dnon-cardiac suornell PreAmerican Col5 or predicting pdministration S WG, Daley Ja after major be MJ et al. Prnormal renal fMet al. Develory: results fromnt with liver disng surgical ris 11. val after abdo94:966 969. A, Unterborn Jantation. Liver nder the 2016)NG ational Emergetical care: the SSUM and Pohe enUmeratiDevelopment ant and evaluatnts and SurgePACHE II andal applicationsE, Lemeshow Sac Surg. 1999 The logistic ESCORE II. Eurty of Thoraciceogh BE, Taylo31. dures. Anesthassification an217-222 aier H. Risk fa568 Derivation andurgery. 1999 Ceoperative pullege of Physicpostoperative Surgical Qualit. Developmennon-cardiac sredictors of pofunction.

10 Anesopment and vam a national dsease. Trans Ask in patients wominal aortic aJN, Pratt DS, Transpl2004 e Commons Laparotocurrent statusortsmouth POon of mortalityand validation ion of the ACSeons. J Amer C ASA scores is. Eur J Surg 1S, Salamon R16(1) Er J CardiothoraSurgeons Nator KM. Generihesiology 1941nd per-operativactors, complicd prospective Circulation 100monary risk scians respiratory faity Improvemennt and validatiourgery. Ann Inostoperative acsthesiology. 20alidation of an ata set. AnestAm Clin Climawith cirrhosis: aneurysm surgKaplan MM. A10:418 424ribution-NonComy- naesthesia-tutoomy Audit. RCs of the APACSSUM for prey and morbiditof the SurgicaS NSQIP surgColl Surg 2013n patients hav1999 165:730-. European syEur Heart J. 2rac Surg. 2012tional Databasic, simple risk 1 2:281-284 ve variables acations and ouvalidation of a0 (10): 1043 1tratification foilure in men afnt Program. Aon of a multifantern Med, 200cute renal failu007.