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An evaluation of the Charlson co-morbidity score for predicting sepsis after elective major surgery.
Hampshire, Peter A; Guha, Arpan; Strong, Ann; Parsons, Dawn; Rowan, Patricia.
Affiliation
  • Hampshire PA; Department of Critical Care Medicine, Royal Liverpool University & Broadgreen Hospitals NHS Trust, Prescot Street, Liverpool L7 8XP, UK.
Indian J Crit Care Med ; 15(1): 30-6, 2011 Jan.
Article in En | MEDLINE | ID: mdl-21633543
BACKGROUND AND AIMS: Severe sepsis is a significant cause of morbidity and mortality following major surgery. The Charlson co-morbidity score (CCS) has been shown to be associated with severe sepsis following major surgery for cancer. This prospective observational study investigated the effect of patient factors (CCS, gender, age and malignancy) and intraoperative factors (duration of surgery and allogeneic blood transfusion) on the incidence of sepsis after elective major surgery, and the impact of patient co-morbidities on length of stay in critical care. MATERIALS AND METHODS: We prospectively identified a cohort of 101 patients undergoing elective major surgery in a university teaching hospital. The CCS was calculated before surgery, and the incidence of sepsis was documented following surgery. We investigated whether age, malignancy, intraoperative allogeneic blood transfusion, length of surgery or gender were associated with sepsis following surgery. RESULTS: Twenty-seven (27%) patients developed sepsis. Using multivariate logistic regression, the duration of surgery was associated with the development of sepsis after surgery (P = 0.054, odds ratio 1.2). The CCS was not associated with sepsis in this population of cancer and non-cancer patients undergoing elective major surgery, but was associated with longer length of stay in the intensive care unit (P = 0.016). CONCLUSIONS: Duration of surgery, but not patient co-morbidity as assessed by the CCS, may predict the postoperative incidence of sepsis. CCS could be used as a guide to predict consumption of critical care resources by elective surgical patients. A higher CCS was associated with a longer ICU stay. Resources, such as postoperative goal directed therapy, may be useful in reducing length of stay, hospital costs and risks of infective complications in this subgroup of patients with higher CCS.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Indian J Crit Care Med Year: 2011 Document type: Article Country of publication: India

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Indian J Crit Care Med Year: 2011 Document type: Article Country of publication: India