Validity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational study

Hdl Handle:
http://hdl.handle.net/10149/581673
Title:
Validity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational study
Authors:
Goodman, B. A. (Ben); Batterham, A. M. (Alan); Kothmann, E. (Elke); Cawthorn, L. (Louise); Yates, D. (David); Melsom, H. (Helen); Kerr, K. (Karen); Danjoux, G. R. (Gerard)
Affiliation:
Teesside University. Health and Social Care Institute.
Citation:
Goodman, B. A., Batterham, A. M., Kothmann, E., Cawthorn, L., Yates, D., Melsom, H., Kerr, K., Danjoux, G. R. (2015) 'Validity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational study' Perioperative Medicine; 4 (1)
Publisher:
BioMed Central
Journal:
Perioperative Medicine
Issue Date:
12-Oct-2015
URI:
http://hdl.handle.net/10149/581673
DOI:
10.1186/s13741-015-0020-1
Additional Links:
http://www.perioperativemedicinejournal.com/content/4/1/10
Abstract:
Background: Currently, there is no standardised tool used to capture morbidity following abdominal aortic aneurysm (AAA) repair. The aim of this prospective observational study was to validate the Postoperative Morbidity Survey (POMS) according to its two guiding principles: to only capture morbidity substantial enough to delay discharge from hospital and to be a rapid, simple screening tool. Methods: A total of 64 adult patients undergoing elective infrarenal AAA repair participated in the study. Following surgery, the POMS was recorded daily, by trained research staff with the clinical teams blinded, until hospital discharge or death. We modelled the data using Cox regression, accounting for the competing risk of death, with POMS as a binary time-dependent (repeated measures) internal covariate. For each day for each patient, ‘discharged’ (yes/no) was the event, with the elapsed number of days post-surgery as the time variable. We derived the hazard ratio for any POMS morbidity (score 1–9) vs. no morbidity (zero), adjusted for type of repair (endovascular versus open), age and aneurysm size. Results: The hazard ratio for alive discharge with any POMS-recorded morbidity versus no morbidity was 0.130 (95 % confidence interval 0.070 to 0.243). The median time-to-discharge was 13 days after recording any POMS morbidity vs. 2 days after scoring zero for POMS morbidity. Compliance with POMS completion was 99.5 %. Conclusions: The POMS is a valid tool for capturing short-term postoperative morbidity following elective infrarenal AAA repair that is substantial enough to delay discharge from hospital. Daily POMS measurement is recommended to fully capture morbidity and allow robust analysis. The survey could be a valuable outcome measure for use in quality improvement programmes and future research.
Type:
Article
Language:
en
Keywords:
Aneurysm; AAA; postoperative; morbidity; POMS; complications
ISSN:
2047-0525
Rights:
Author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo [Accessed: 04/11/2015]

Full metadata record

DC FieldValue Language
dc.contributor.authorGoodman, B. A. (Ben)en
dc.contributor.authorBatterham, A. M. (Alan)en
dc.contributor.authorKothmann, E. (Elke)en
dc.contributor.authorCawthorn, L. (Louise)en
dc.contributor.authorYates, D. (David)en
dc.contributor.authorMelsom, H. (Helen)en
dc.contributor.authorKerr, K. (Karen)en
dc.contributor.authorDanjoux, G. R. (Gerard)en
dc.date.accessioned2015-11-04T11:21:21Zen
dc.date.available2015-11-04T11:21:21Zen
dc.date.issued2015-10-12en
dc.identifier.citationPerioperative Medicine; 4 (1)en
dc.identifier.issn2047-0525en
dc.identifier.doi10.1186/s13741-015-0020-1en
dc.identifier.urihttp://hdl.handle.net/10149/581673en
dc.description.abstractBackground: Currently, there is no standardised tool used to capture morbidity following abdominal aortic aneurysm (AAA) repair. The aim of this prospective observational study was to validate the Postoperative Morbidity Survey (POMS) according to its two guiding principles: to only capture morbidity substantial enough to delay discharge from hospital and to be a rapid, simple screening tool. Methods: A total of 64 adult patients undergoing elective infrarenal AAA repair participated in the study. Following surgery, the POMS was recorded daily, by trained research staff with the clinical teams blinded, until hospital discharge or death. We modelled the data using Cox regression, accounting for the competing risk of death, with POMS as a binary time-dependent (repeated measures) internal covariate. For each day for each patient, ‘discharged’ (yes/no) was the event, with the elapsed number of days post-surgery as the time variable. We derived the hazard ratio for any POMS morbidity (score 1–9) vs. no morbidity (zero), adjusted for type of repair (endovascular versus open), age and aneurysm size. Results: The hazard ratio for alive discharge with any POMS-recorded morbidity versus no morbidity was 0.130 (95 % confidence interval 0.070 to 0.243). The median time-to-discharge was 13 days after recording any POMS morbidity vs. 2 days after scoring zero for POMS morbidity. Compliance with POMS completion was 99.5 %. Conclusions: The POMS is a valid tool for capturing short-term postoperative morbidity following elective infrarenal AAA repair that is substantial enough to delay discharge from hospital. Daily POMS measurement is recommended to fully capture morbidity and allow robust analysis. The survey could be a valuable outcome measure for use in quality improvement programmes and future research.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.perioperativemedicinejournal.com/content/4/1/10en
dc.rightsAuthor can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo [Accessed: 04/11/2015]en
dc.subjectAneurysmen
dc.subjectAAAen
dc.subjectpostoperativeen
dc.subjectmorbidityen
dc.subjectPOMSen
dc.subjectcomplicationsen
dc.titleValidity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational studyen
dc.typeArticleen
dc.contributor.departmentTeesside University. Health and Social Care Institute.en
dc.identifier.journalPerioperative Medicineen
or.citation.harvardGoodman, B. A., Batterham, A. M., Kothmann, E., Cawthorn, L., Yates, D., Melsom, H., Kerr, K., Danjoux, G. R. (2015) 'Validity of the Postoperative Morbidity Survey after abdominal aortic aneurysm repair—a prospective observational study' Perioperative Medicine; 4 (1)en
dc.date.accepted09-23-2015en
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