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Article

The Extended Postoperative Care-Score (EXPO-Score)—An Objective Tool for Early Identification of Indication for Extended Postoperative Care

1
Department of Anesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
2
Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
3
Department of Anesthesiology and Intensive Care Medicine, Friedrich-Ebert-Hospital, 24536 Neumünster, Germany
*
Author to whom correspondence should be addressed.
T.I. and A.C. contributed equally to this article.
J. Clin. Med. 2019, 8(10), 1666; https://doi.org/10.3390/jcm8101666
Received: 24 September 2019 / Revised: 6 October 2019 / Accepted: 9 October 2019 / Published: 12 October 2019
(This article belongs to the Special Issue Anesthesia for the High-Risk Patient)
Extended postoperative care and intensive care unit capacity is limited and efficient patient allocation is mandatory. This study aims to develop an effective yet simple score to predict indication for extended postoperative care, as there is a lack of objective criteria for early prediction of admission to extended care in surgical patients. This prospective observational study was divided into two periods (Period 1: Extended Postoperative Care-Score (EXPO)-Score generation; Period 2: EXPO-Score validation) and it was performed at a tertiary university center in Germany. A total of 4042 (Period 1) and 2198 (Period 2) adult patients ≥ 18 years old receiving elective or emergency surgery were included in this study. After identifying patient- and surgery-related risk factors by an expert panel, the EXPO-Score was developed through logistic regression from data of Period 1 and validated in Period 2. Three risk factors are sufficient for generating a reliable predictive EXPO-Score: (1) the American Society of Anesthesiologists’ (ASA) physical status, (2) cardiopulmonary physical exercise status expressed in metabolic equivalents (MET), and (3) the type of surgery. The score threshold (0.23) has a sensitivity of 0.87, a specificity of 0.91, and an accuracy of 0.90 for predicting indication for extended postoperative care. The EXPO-Score provides a validated, early collectable, and easy-to-use tool for predicting indication of extended postoperative care in adult surgical patients. View Full-Text
Keywords: Intensive Care Unit; extended postoperative care; risk score; ICU Bed Shortage; objective allocation; patient pathway; patient safety Intensive Care Unit; extended postoperative care; risk score; ICU Bed Shortage; objective allocation; patient pathway; patient safety
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MDPI and ACS Style

Iden, T.; Caliebe, A.; Renner, J.; Hertz, M.-B.; Höcker, J.; Suvanto-Scholz, P.; Steinfath, M.; Weiler, N.; Gruenewald, M. The Extended Postoperative Care-Score (EXPO-Score)—An Objective Tool for Early Identification of Indication for Extended Postoperative Care. J. Clin. Med. 2019, 8, 1666. https://doi.org/10.3390/jcm8101666

AMA Style

Iden T, Caliebe A, Renner J, Hertz M-B, Höcker J, Suvanto-Scholz P, Steinfath M, Weiler N, Gruenewald M. The Extended Postoperative Care-Score (EXPO-Score)—An Objective Tool for Early Identification of Indication for Extended Postoperative Care. Journal of Clinical Medicine. 2019; 8(10):1666. https://doi.org/10.3390/jcm8101666

Chicago/Turabian Style

Iden, Timo, Amke Caliebe, Jochen Renner, Maj-Britt Hertz, Jan Höcker, Päivi Suvanto-Scholz, Markus Steinfath, Norbert Weiler, and Matthias Gruenewald. 2019. "The Extended Postoperative Care-Score (EXPO-Score)—An Objective Tool for Early Identification of Indication for Extended Postoperative Care" Journal of Clinical Medicine 8, no. 10: 1666. https://doi.org/10.3390/jcm8101666

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