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Perioperative mortality score: data collection and cost.

S Achuthan¹, A Smirk, A Keeble

¹Department of Anaesthesia, Royal Melbourne Hospital, Melbourne and Ballarat Base Hospital, Ballarat, Victoria, Australia.

Anaesthesia and Intensive Care

|April 14, 2011

Summary

Routine calculation of the perioperative mortality score for elderly surgical patients is costly, with essential lab tests performed in only 47% of cases. This study assessed the incidence and cost of these tests for future research considerations.

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Area of Science:

Geriatric Medicine
Surgical Outcomes Research
Health Economics

Background:

The perioperative mortality score aids in predicting mortality for elderly patients undergoing noncardiac surgery.
The score incorporates preoperative risk factors and postoperative complications.
The cost-effectiveness of routine score calculation requires evaluation.

Purpose of the Study:

To audit the incidence of laboratory tests required for the perioperative mortality score in elderly patients undergoing noncardiac surgery.
To determine the cost associated with routine calculation of the perioperative mortality score.
To inform future research and clinical application of the score.

Main Methods:

A 3-month audit of clinician-initiated laboratory tests (albumin, creatinine, white cell count) in patients aged >= 70 years undergoing noncardiac surgery.

Related Experiment Videos

Inclusion criteria: elective/emergency noncardiac surgery requiring at least overnight admission.

Recruited 637 patients.

Main Results:

Laboratory tests for the perioperative mortality score were completed in only 47% of patients.
The total cost for testing all untested patients was A$12,057 (A$18,927 per 1000 patients).
Prevalence of key findings: 11% hypoalbuminemia, 24% acute renal impairment, 33% high white cell count.

Conclusions:

Routine calculation of the perioperative mortality score is not consistently performed due to incomplete laboratory testing.
The cost of comprehensive testing is substantial, potentially limiting widespread implementation.
Findings provide data for future research on the score's utility and cost-effectiveness.