The WHO2SAFE Score: A Predictive Tool for Postoperative Oxygen Requirement After PACU Recovery

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Health Services Research

Background:

• Postoperative respiratory complications are a significant concern.
• Efficient management of supplemental oxygen is crucial for patient outcomes and resource allocation.

Purpose of the Study:

• To develop and validate a predictive scoring system for postoperative oxygen requirements.
• To enhance clinical decision-making in postoperative respiratory care.
• To reduce unnecessary oxygen administration and optimize resource utilization.

Main Methods:

• Retrospective analysis of 42,378 patients undergoing elective non-cardiac surgery with general anesthesia (2018-2022).
• Identification of predictors for supplemental oxygen requirement at Post-Anesthesia Care Unit (PACU) discharge.
• Development of the WHO2SAFE scoring system based on significant risk factors.

Main Results:

• 14.9% of patients required supplemental oxygen at PACU discharge.
• The WHO2SAFE score (0-15) incorporates eight risk factors: intraoperative wheezing, hypotension, obesity, prolonged operative time (≥180 min), sleep apnea, high ASA classification (≥3), female sex, and elderly status.
• A WHO2SAFE score of 6 was identified as a cutoff for high-risk patients.

Conclusions:

• The WHO2SAFE score is a practical tool for predicting postoperative oxygen needs.
• Web-based accessibility of the score facilitates early intervention and efficient resource management.
• The score aids in identifying patients requiring close observation while minimizing oxygen use in low-risk individuals.