News & Events 

 

9/30/2014: Dr. Heena Santry has been awarded an R01 (Independent Investigator Research Grant) from the Agency for Healthcare Research & Quality for her project entitled "A New Specialty Responding To National Needs: Does Acute Care Surgery Deliver?" (Grant #1 R01 HS022694-01A1). The project focuses on an ongoing crisis in access to care for time-sensitive surgical diseases such as perforated bowel or necrotizing soft tissue infections that is expected to worsen based on current surgical workforce trends and the aging US population. The research will examine the ongoing diffusion of a new specialty called acute care surgery as a strategy to meet our nation’s emergency general surgery needs and will measure which specific structures and processes optimize outcomes for patients with general surgery emergencies. The results of this project will help develop organized systems for the care of emergency general surgery patients so that all Americans suffering general surgery emergencies will have timely access to high quality surgical care regardless of when and where they are stricken.


» Click to read more news about UMass Surgery

 

Predicting Major Postoperative In-Hospital Complications after Laparoscopic Cholecystectomy: A Simple Risk Score

 Melissa M. Murphy, MD, MPH, Shimul Shah, MD, Jessica P. Simons, MD, Nicholas G. Csikesz, BS, Sing-Chau Ng, MS 

Zheng Zhou MD, PhD, Jennifer F. Tseng, MD, MPH

Accepted for oral presentation at the Surgical Society of the Alimentray Tract (SSAT) Annual Meeting, Digestive Diseases Week (DDW), Chicago, IL, June 2009; manuscript submitted to Journal of Gastroinstinal Surgery

Step 1. Calculate Charlson comorbidity score
Indicate "yes" for the comorbidities that the patient has. This validated algorithm (Charlson, ME et al. J Chron Dis 1987; 40(5):373-83.) assigns a point value to the various diseases. The patient's raw score will then be reassigned into the collapsed Charlson score groups for use in the risk score calculation. Group 1 is a score of zero or 1, Group 2 is a score of 2, Group 3 is a score of 3 or higher.

Comorbidities

Points

AIDS   
Cerebrovascular Disease   
Chronic Pulmonary Disease   
Congestive Heart Failure   
Connective Tissue/Rheumatic Disease   
Dementia   
Diabetes Without End Organ Damage   
Diabetes With End Organ Damage   
Hemiplegia   
Liver Disease Mild to Moderate   
Liver Disease Severe   
Myocardial Infarction   
Peripheral Vascular Disease   
Renal Disease   
Ulcer Disease   
 
Charlson Group Score 

 

Step 2. Calculate the risk score, including the Charlson group.
Patient sex, age, Charlson score group, presence of biliary tract inflammation (acute or chronic cholecystitis, cholangitis) or cancer, admission type, and hospital teaching status are indicated. The point values are assigned accordingly to yield an additive score. By clicking on the "Calculate Estimated Risk of Major Postoperative Complication" button, this score is then assigned to the appropriate risk score group, and the risk for that group is displayed. 

Previously validated major postoperative complications (Lawthers, AG et al. Med Care 2000; 38(8):785-95.) evaluated by the model include, postoperative infection, myocardial infarction, aspiration pneumonia, pulmonary compromise, gastrointestinal hemorrhage, reopening a surgical site, deep venous thrombosis/ pulmonary emobolism, and laceration/perforation.

Factor

Level

Point Value

Sex     
Age Group     
Charlson Score
Biliary Tract Inflammation/Cancer     
Admission Type     
Hospital Type     
 
 
Final Murphy