cliot (version 1.0.0)

pmp_mortality_score: Preoperative Mortality Predictor (PMP) Score

Description

Calculates the Preoperative Mortality Predictor (PMP) Score, a risk stratification tool developed from the ACS-NSQIP database to predict 30-day mortality in general surgery patients. The score sums points assigned to 14 preoperative variables, including age, comorbidities, and functional status.

Usage

pmp_mortality_score(age, inpatient_status, sepsis, poor_functional_status,
                    disseminated_cancer, cardiac_comorbidity, pulmonary_comorbidity,
                    renal_comorbidity, liver_comorbidity, steroid_use, weight_loss,
                    bleeding_disorder, dnr_status, obesity)

Value

A list containing:

PMP_Score

The calculated total risk score.

Interpretation

General interpretation of the score (Higher score indicates higher mortality risk).

Arguments

age

Numeric. Patient age in years. (<65: 0, 65-69: 0.5, 70-79: 1, >=80: 2).

inpatient_status

Numeric (0 or 1). Is the patient an inpatient? (1 = Yes, +6 pts).

sepsis

Numeric (0 or 1). Presence of sepsis, severe sepsis, or septic shock within 48 hours prior to surgery. (1 = Yes, +4 pts).

poor_functional_status

Numeric (0 or 1). Totally dependent functional status (requires total assistance for all daily activities). (1 = Yes, +3 pts).

disseminated_cancer

Numeric (0 or 1). Disseminated cancer. (1 = Yes, +1 pt).

cardiac_comorbidity

Numeric (0 or 1). Presence of cardiac comorbidities (History of CHF, MI, Angina, Peripheral Artery Disease, or Hypertension requiring medication). (1 = Yes, +5 pts).

pulmonary_comorbidity

Numeric (0 or 1). Presence of pulmonary comorbidities (Ventilator dependence, COPD, or current Pneumonia). (1 = Yes, +3 pts).

renal_comorbidity

Numeric (0 or 1). Presence of renal comorbidities (Dialysis or Acute Renal Failure). (1 = Yes, +1 pt).

liver_comorbidity

Numeric (0 or 1). Presence of liver comorbidities (Ascites or Esophageal Varices). (1 = Yes, +1 pt).

steroid_use

Numeric (0 or 1). Chronic steroid use for a chronic condition. (1 = Yes, +1 pt).

weight_loss

Numeric (0 or 1). >10% loss of body weight in the last 6 months. (1 = Yes, +1 pt).

bleeding_disorder

Numeric (0 or 1). Presence of a bleeding disorder. (1 = Yes, +1 pt).

dnr_status

Numeric (0 or 1). Do Not Resuscitate (DNR) status. (1 = Yes, +1 pt).

obesity

Numeric (0 or 1). Obesity (BMI >= 30 kg/m^2). (1 = Yes, -1 pt).

References

Ghanem OM, et al. Predicting risk of death in general surgery patients on the basis of preoperative variables using American College of Surgeons National Surgical Quality Improvement Program data. Perm J. 2012;16(4):9-15. doi:10.7812/TPP/12-019

Examples

# Example 1: High Risk
# 80yo (+2), Inpatient (+6), Cardiac (+5), Sepsis (+4)
# Score = 17
pmp_mortality_score(80, 1, 1, 0, 0, 1, 0, 0, 0, 0, 0, 0, 0, 0)

# Example 2: Low Risk
# 45yo (0), Obesity (-1), No other factors
# Score = -1
pmp_mortality_score(45, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 1)