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Neuro-POMS: validation of a dedicated tool for the assessment of early post-operative morbidity in neurosurgery
British Journal of Neurosurgery ; 35(4):504-505, 2021.
Article in English | EMBASE | ID: covidwho-1612281
ABSTRACT

Objectives:

The Post-operative Morbidity Survey (POMS) identifies post-operative morbidity in patients undergoing elective major surgery. The POMS was useful in various surgical fields including neurosurgery;however, a dedicated neurosurgical version of the POMS is not available. This study describes the creation, validation process, and utility of a dedicated neurosurgical POMS the neuro-POMS.

Design:

Single-centre retrospective study including a consecutive series of patients undergoing major neurosurgical cranial procedures over three months (pre-COVID).

Methods:

Data on post-operative morbidity was collected and used to design a dedicated Neuro-POMS. The Neuro- POMS was applied to the same patient group by an independent assessor who was blinded to the initial data collection. Results of the generic POMS and neuro-POMS were compared.

Results:

One hundred and forty-seven patients (mean age 52, 90 females) underwent major cranial neurosurgery during the study period. The neuro-POMS assessment revealed early post-operative morbidity in 65% of the patients on a postoperative day 3 and 57% on day 8. The sensitivity of neuro- POMS was significantly higher compared to the generic version of the POMS (Fisher exact tests p < 0.001 for day 3 and p = 0.03 for day 8). Additionally, morbidity detected by the neuro-POMS allowed early prediction of the overall postoperative length of stay. Every positive item of the neuro- POMS on day 3 predicted an increase of 1.7 days in the overall length of stay (linear regression, p < 0.001, 95%CI 1.2-2.1). For day 8, the predicted increase in length of stay was 3.2 days (linear regression, p < 0.001, 95%CI 2.5-3.7).

Conclusions:

Neuro-POMS is a valuable tool for the early detection of post-operative morbidity after cranial neurosurgery. It is more sensitive than POMS in detecting morbidity and can predict overall hospital length of stay. Neuro-POMS could also be useful in the management of hospital beds.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: British Journal of Neurosurgery Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: British Journal of Neurosurgery Year: 2021 Document Type: Article