Comparative evaluation of scales for predicting an unfavorable postoperative outcome: Preliminary results of the multicenter study “The role of concomitant diseases in the stratification of the risk of postoperative complications in abdominal surgery STOPRISK”
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Keywords

Prognosis
Risk Assessment
Postoperative Complications
Treatment Outcome
Fatal Outcome
Hospital Mortality

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Zabolotskikh IB, Trembach NV, Magomedov MA, Krasnov VG, Chernienko LY, Shevyrev SN, Popov AS, Tyutyunova EV, Vatutin SN, Malyshev YP, Popov EA, Smolin AA, Kitiashvili IZ, Dmitriev AA, Grigoryev EV, Kameneva EA, Fisher VV, Volkov EV, Yatsuk IV, Levit DA, Sharipov AM, Khoronenko VE, Shemetova MM, Kokhno VN, Polovnikov EV, Spasova AP, Mironov AV, Davydova VR, Shapovalov KG, Gritsan AI, Sorsunov SV, Lebedinskii KM, Dunts PV, Rudnov VA, Stadler VV, Bayalieva AZ, Prigorodov MV, Antonov VF, Voroshin DG, Ovezov AM, Pivovarova AA, Martynov DV, Batigyan OA, Zamyatin MN, Voskanyan SE, Astakhov AA, Khoteev AZ, Protsenko DN, Arikan NG, Zakharchenko IA, Matveev AS, Trembach IA, Musaeva TS Comparative evaluation of scales for predicting an unfavorable postoperative outcome: Preliminary results of the multicenter study “The role of concomitant diseases in the stratification of the risk of postoperative complications in abdominal surgery STOPRISK”. Annals of Critical Care. 2022;(3):27–44. doi:10.21320/1818-474X-2022-3-27-44.

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Abstract

INTRODUCTION. The need for accurate risk stratification is obvious. Modern methods are quite cumbersome, which can cause difficulties when applied in routine practice, and therefore relatively simple but accurate forecasting methods have become very popular, which, however, have not been validated in Russia: SORT (Surgical Outcome Risk Tool), SRS (Surgical Risk Scale), POSPOM (Preoperative Score to Predict Postoperative Mortality), NZRISK (New Zealand RISK), SMPM (Surgical Mortality Probability Model). OBJECTIVES. The aim of this work is to determine the prognostic value of risk assessment scales in predicting an unfavorable postoperative outcome based on the analysis of data obtained in the STOPRISK study in patients undergoing open abdominal surgery. MATERIALS AND METHODS. The analysis of data on perioperative parameters of 1,179 patients who underwent open abdominal surgery is presented. RESULTS. The fatal outcome was recorded in 14 patients (1.18 %). A total of 135 complications were registered in 92 patients (7.8 %). All scales demonstrated satisfactory prognostic value in assessing the risk of complications (the area under the operating characteristic curve (AUROC) for the Physical Status Scale of the American Society of Anesthesiologists (ASA) was 0.714 (0.687–0.739), for the Surgical Risk Scale (SRS) — 0.727 (0.701–0.753), for the Surgical Outcome Risk Scale (SORT) — 0.738 (0.712–0.763), for the New Zealand Risk Scale (NZRISK) — 0.763 (0.738–0.787), for the Surgical Mortality Probability Scale (SMPM) — 0.732 (0.706–0.757), for the Preoperative Postoperative mortality Prediction Scale (POSPOM) — 0.764 (0.738–0.788)) and good in assessing the risk of death (AUROC for the ASA scale was 0.82 (0.804–0.843), for the SRS scale — 0.860 (0.838–0.879), for the SORT scale — 0.860 (0.838–0.879), for the NZRISK scale — 0.807 (0.783–0.829), for the SMPM scale — 0.852 (0.831–0.872), for the POSPOM scale — 0.811 (0.788–0.833)). CONCLUSIONS. All the studied scales have good prognostic value in assessing the risk of 30-day mortality after major abdominal surgery. The NZRISK and POSPOM scales demonstrate good prognostic value for cardiovascular complications, POSPOM and SRS scales — for acute renal injury. POSPOM and NZRISK scales showed an excellent prognostic value in relation to the risk of postoperative delirium.
https://doi.org/10.21320/1818-474X-2022-3-27-44
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