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Journal of Gastrointestinal Surgery

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01-08-2009 | Review Article

A Review of Risk Scoring Systems Utilised in Patients Undergoing Gastrointestinal Surgery

Authors: Aninda Chandra, Sudhakar Mangam, Deya Marzouk

Published in: Journal of Gastrointestinal Surgery | Issue 8/2009

Abstract

Introduction

Adequate stratification and scoring of risk is essential to optimise clinical practice; the ability to predict operative mortality and morbidity is important. This review aims to outline the essential elements of available risk scoring systems in patients undergoing gastrointestinal surgery and their differences in order to enable effective utilisation.

Methods

The English literature was searched over the last 50 years to provide an overview of systems pertaining to the adult surgical patient.

Discussion

Scoring systems can provide objectivity and mortality prediction enabling communication and understanding of severity of illness. Incorporating subjective factors within scoring systems can allow clinicians to apply their experience and understanding of the situation to an individual but are not reproducible. Limitations relating to obtaining variables, calculating predicted mortality and applicability were present in most systems. Over time scoring systems have become out-dated which may reflect continuing improvement in care. APACHE II shows the importance of reproducibility and comparability particularly when assessing critically ill patients. Both NSQIP in the USA and P-POSSUM in the UK seem to have many benefits which derive from their comprehensive dataset. The “Surgical Apgar” score offers relatively objective criteria which contrasts against the subjective nature of the ASA score.

Conclusion

P-POSSUM and NSQIP are comprehensive but are difficult to calculate. In the search for a simple and easy to calculate score, the “Surgical Apgar” score may be a potential answer. However, more studies need to be performed before it becomes as widely taken up as APACHE II, NSQIP and P-POSSUM.

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Title: A Review of Risk Scoring Systems Utilised in Patients Undergoing Gastrointestinal Surgery
Authors: Aninda Chandra
Sudhakar Mangam
Deya Marzouk
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-009-0857-z

At a glance: The STEP trials

Springer Medicine

A Review of Risk Scoring Systems Utilised in Patients Undergoing Gastrointestinal Surgery

Abstract

Introduction

Methods

Discussion

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Discussion

Conclusion

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