Integration of functional capacity to medically necessary, time-sensitive scoring system: A prospective observational study.


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Koltka A. K., Dinçer M. B., Güzel M., Orhan-Sungur M., Özkan-Seyhan T., Altun D., ...Daha Fazla

Saudi medical journal, cilt.44, sa.9, ss.921-932, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 44 Sayı: 9
  • Basım Tarihi: 2023
  • Doi Numarası: 10.15537/smj.2023.44.9.20230318
  • Dergi Adı: Saudi medical journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, Veterinary Science Database
  • Sayfa Sayıları: ss.921-932
  • Anahtar Kelimeler: elective surgical procedures, intensive care units, metabolic equivalent, triage
  • İstanbul Üniversitesi Adresli: Hayır

Özet

OBJECTIVES: To evaluate 2 new modifications to medically necessary, time-sensitive (MeNTS) scoring systems integrating functional capacity assessment in estimating intensive care unit (ICU) requirements. METHODS: This prospective observational study included patients undergoing elective surgeries between July 2021 and January 2022. The MeNTS scores and our 2 modified scores: MeNTS-METs (integrated Duke activity status index [DASI] as metabolic equivalents [METs]) and MeNTS-DASI-5Q (integrated modified DASI [M-DASI] as 5 questions) were calculated. The patients' ICU requirements (group ICU+ and group ICU-), DASIs, patient-surgery-anesthesia characteristics, hospital stay lengths, rehospitalizations, postoperative complications, and mortality were recorded. RESULTS: This study analyzed 718 patients. The MeNTS, MeNTS-METs, and MeNTS-DASI-5Q scores were higher in group ICU+ than in group ICU- (p<0.001). Group ICU+ had longer operation durations and hospital stay lengths (p<0.001), lower DASI scores (p<0.001), and greater hospital readmissions, postoperative complications, and mortality (p<0.001). The MeNTS-METs and MeNTS-DASI-5Q scores better predicted ICU requirement with areas under the receiver operating characteristic curve (AUC) of 0.806 and 0.804, than the original MeNTS (AUC=0.782). CONCLUSION: The 5-questionnaire M-DASI is easy to calculate and, when added to a triage score, is as reliable as the original DASI for predicting postoperative ICU requirements.