Morbidity

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Harry Van Goor - One of the best experts on this subject based on the ideXlab platform.

Michael G Mythen - One of the best experts on this subject based on the ideXlab platform.

  • The development of a postoperative Morbidity score to assess total Morbidity burden after cardiac surgery
    Journal of Clinical Epidemiology, 2012
    Co-Authors: Julie Sanders, Michael G Mythen, John Browne, J. Van Der Meulen, Bruce E. Keogh, Tom Treasure, Hugh Montgomery
    Abstract:

    Abstract Objective To develop a tool for identifying and quantifying Morbidity following cardiac surgery (cardiac postoperative Morbidity score [C-POMS]). Study Design and Setting Morbidity was prospectively assessed in 450 cardiac surgery patients on postoperative days 1, 3, 5, 8, and 15 using POMS criteria (nine postoperative Morbidity domains in general surgical patients) and cardiac-specific variables (from expert panel). Other morbidities were noted as free text and included if prevalence was more than 5%, missingness less than 5%, and mean expert-rated severity-importance index score more than 8. Construct validity was assessed by expert panel review, Cronbach’s alpha (internal consistency), and linear regression (predictive ability of C-POMS for length of stay [LOS]). Results A 13-domain model was derived. Internal consistency (>0.7) on D3–D15 permits use as a summative score of total Morbidity burden. Mean C-POMS scores were 3.4 (D3), 2.6 (D5), 3.4 (D8), and 3.8 (D15). Patient LOS was 4.6 days ( P  = 0.012), 5.3 days ( P  = 0.001), and 7.6 days ( P  = 0.135) longer in patients with C-POMS-defined Morbidity on D3, D5, D8, and D15, respectively, than in those without. For every unit increase in C-POMS summary score, subsequent LOS increased by 1.7 (D3), 2.2 (D5), 4.5 (D8), and 6.2 (D15) days (all P  = 0.000). Conclusion C-POMS is the first validated tool for identifying total Morbidity burden after cardiac surgery. However, further external validation is warranted.

  • The Postoperative Morbidity Survey was validated and used to describe Morbidity after major surgery
    Journal of Clinical Epidemiology, 2007
    Co-Authors: Michael P. W. Grocott, John Browne, J. Van Der Meulen, C Matejowsky, M Mutch, Mark Hamilton, Denny Z. H. Levett, Mark Emberton, Fares S. Haddad, Michael G Mythen
    Abstract:

    OBJECTIVES: To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative Morbidity after major elective surgery using the POMS. STUDY DESIGN AND SETTING: This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative Morbidity, was recorded on postoperative days 3, 5, 8, and 15. RESULTS: Inter-rater reliability was perfect for 11/18 items (Kappa=1.0), with Kappa=0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of Morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined Morbidity was present in 325 of 433 patients (75.1%) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1%) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of Morbidity. CONCLUSION: The POMS is a reliable and valid survey of short-term postoperative Morbidity in major elective surgery. Many patients remain in hospital without any Morbidity as recorded by the POMS.

  • The Postoperative Morbidity Survey was validated and used to describe Morbidity after major surgery
    J CLIN EPIDEMIOL, 2007
    Co-Authors: Michael G Mythen
    Abstract:

    Objectives: To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative Morbidity after major elective surgery using the POMS.Study Design and Setting: This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative Morbidity, was recorded on postoperative days 3, 5, 8, and 15.Results: Inter-rater reliability was perfect for 11/18 items (Kappa = 1.0), with Kappa = 0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of Morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined Morbidity was present in 325 of 433 patients (75.1 %) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1 %) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of Morbidity.Conclusion: The POMS is a reliable and valid survey of short-term postoperative Morbidity in major elective surgery. Many patients remain in hospital without any Morbidity as recorded by the POMS. (c) 2007 Elsevier Inc. All rights reserved.

Richard Ten P G Broek - One of the best experts on this subject based on the ideXlab platform.

Michael P. W. Grocott - One of the best experts on this subject based on the ideXlab platform.

  • Measuring Morbidity following major surgery
    2010
    Co-Authors: Michael P. W. Grocott
    Abstract:

    A systematic review of the efficacy of a specific perioperative haemodynamic management strategy was performed to explore the balance between therapeutic benefit and adverse effects. Whilst mortality and length of hospital stay were reduced in the intervention group, pooling of Morbidity data for between-group comparisons was limited by the heterogeneity of Morbidity reporting between different studies. Classification, criteria and summation of Morbidity outcome variables were inconsistent between studies, precluding analyses of pooled data for many types of Morbidity. A similar pattern was observed in a second systematic review of randomised controlled trials of perioperative interventions published in high impact surgical journals. The Post-operative Morbidity Survey (POMS), a previously published method of describing short-term postoperative Morbidity, lacked validation. The POMS was prospectively collected in 439 patients undergoing elective major surgery in a UK teaching hospital. The prevalence and pattern of Morbidity was described and compared with data from a similar study using the POMS in a US institution. The type and severity of surgery was reflected in the frequency and pattern of POMS defined postoperative Morbidity. In the UK institution, many patients remained in hospital without Morbidity as defined by the POMS, in contrast to the US institution, where very few patients remained in hospital in the absence of POMS defined Morbidity. The POMS may have utility as a tool for recording bed occupancy and for modelling bed utilization. Inter-rater reliability was adequate and a priori hypotheses that the POMS would discriminate between patients with known measures of Morbidity risk, and predict length of stay were generally supported through observation of data trends. The POMS was a valid descriptor of short-term post-operative Morbidity in major surgical patients.

  • The Postoperative Morbidity Survey was validated and used to describe Morbidity after major surgery
    Journal of Clinical Epidemiology, 2007
    Co-Authors: Michael P. W. Grocott, John Browne, J. Van Der Meulen, C Matejowsky, M Mutch, Mark Hamilton, Denny Z. H. Levett, Mark Emberton, Fares S. Haddad, Michael G Mythen
    Abstract:

    OBJECTIVES: To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative Morbidity after major elective surgery using the POMS. STUDY DESIGN AND SETTING: This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative Morbidity, was recorded on postoperative days 3, 5, 8, and 15. RESULTS: Inter-rater reliability was perfect for 11/18 items (Kappa=1.0), with Kappa=0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of Morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined Morbidity was present in 325 of 433 patients (75.1%) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1%) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of Morbidity. CONCLUSION: The POMS is a reliable and valid survey of short-term postoperative Morbidity in major elective surgery. Many patients remain in hospital without any Morbidity as recorded by the POMS.

Robert P Bleichrodt - One of the best experts on this subject based on the ideXlab platform.

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