A Comparison of the Charlson Comorbidity Index (CCI) vs POSSUM Score for Prediction of Perioperative Complications in Patients Undergoing Oncogynecologic Surgery
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 300
- 试验地点
- 1
- 主要终点
- Comparison of CCI and POSSUM to predict perioperative complications
研究概览
简要总结
With the global rates of gynecologic cancers on the rise, optimizing perioperative care is imperative. Accurate risk prediction is essential for enhancing patient care, directing preoperative interventions, and facilitating informed decision-making in oncology. This research compares two widely-used risk assessment tools: the Charlson Comorbidity Index (CCI) and the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), in predicting perioperative outcomes. The CCI predominantly addresses comorbidities, providing simplicity and broad applicability, while POSSUM incorporates both physiological and operative factors for a more comprehensive risk assessment. Despite their application across various surgical specialties, the specific utility of these tools in onco-gynecologic surgery remains insufficiently explored. The study aims to evaluate the effectiveness of CCI and POSSUM in predicting perioperative complications, with a focus on the incidence of these complications, length of hospital stay, and 30-day mortality. The implementation of these risk tools may enhance multidisciplinary risk management, thus improving patient outcomes in gynecologic oncology surgery.
详细描述
Onco-gynecologic surgeries, including procedures for ovarian, cervical, uterine, and vulvar cancers, are complex and challenging due to both the technical intricacies of the surgeries and the often compromised health of cancer patients. These procedures carry significant perioperative risks, making optimization of perioperative care critical, especially as global cases of gynecological cancers rise, with millions affected annually. Accurate risk prediction is vital to improve patient outcomes, allowing surgeons and anesthesiologists to tailor preoperative interventions and intraoperative management. These strategies help in identifying high-risk patients, implementing enhanced monitoring, specific anesthetic techniques, or staged surgical approaches to mitigate potential complications.
Two prominent risk assessment tools used in surgical practice are the Charlson Comorbidity Index (CCI) and the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM). The CCI, is a weighted index that considers the number and severity of comorbid conditions to predict mortality risk. Its simplicity and reliance on readily available clinical information have led to its widespread adoption in clinical and research settings. Studies have validated its predictive value across various surgical populations, including oncology patients, although its specific utility in onco-gynecologic surgeries needs further exploration.
In contrast, the POSSUM score offers a more comprehensive risk assessment by incorporating both physiological and operative factors. It includes preoperative variables like age and cardiac signs and considers operative factors like procedural complexity and blood loss. This dual approach provides a nuanced prediction of perioperative risk, useful across diverse surgical fields. Despite POSSUM's broad application, its effectiveness specifically in onco-gynecologic surgeries requires additional investigation to fully ascertain its predictive accuracy and utility.
Currently, our center conducts preoperative evaluations involving anesthesiologists and gynecologists, yet formal risk assessments using CCI or POSSUM have not been implemented. Incorporating these tools could enhance multidisciplinary risk management, involving anesthetic teams, ward nurses, gynecologic oncologists, and intensivists. By systematically evaluating patient history, these indices can promote effective interdisciplinary communication, significantly improve patient safety, and optimize surgical outcomes.
This study aims to compare CCI and POSSUM in predicting perioperative complications, including both anesthetic and surgical complications in onco-gynecologic surgery. Additionally, it seeks to report the incidence of complications, length of hospital stay, and 30-day mortality, providing valuable insights into optimizing patient care in this challenging field.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Age > 18 years
- •Patient underwent elective onco-gynecologic surgery
排除标准
- •Patient required emergency surgery from any indication
- •Patient chart that not contained primary outcome data eg. absent of the anesthetic record
结局指标
主要结局
Comparison of CCI and POSSUM to predict perioperative complications
时间窗: from the date of starting surgery to the date of hospital discharge, up to 30 days
To compare the prediction of perioperative anesthetic and surgical morbidity by the Charlson-Comorbidity Index versus POSSUM score in patients undergoing elective onco-gynecological surgery
次要结局
- Mortality rate(From the day of surgery to 30 days post operation)
- Intraoperative hypotension(Within 24 hours from starting of surgery)
- Quantity of intraoperative blood loss(Within 24 hours from starting of surgery)
- Rate of blood transfusion(Within 24 hours from starting of surgery)
- Rate of vasopressor usage(from the time staring of surgery to the time of finishing surgery, up to 12 hours)
- Clavian-Dindo classification of surgical complications(from the date of starting surgery to the date of hospital discharge, up to 30 days)
- ICU admission(within 24 hours postoperative)
- Reoperation(within 24 hours postoperative)
- Myocardial infarction or myocardial injury(from the date of starting surgery to the date of hospital discharge, up to 30 days)
- Acute kidney injury(from the date of starting surgery to the date of hospital discharge, up to 30 days)
- Postoperative pulmonary complications(from surgery from the date of starting surgery to the date of hospital discharge, up to 30 days)