The Use of Lee's Index as a Genuine Assessment of Outcome in the Perioperative Period
Peter Moran, Trevor Ghidella, Anthony Jenkins, Douglas Whittle
Princess Alexandra Hospital, Brisbane
In 1999, Lee et al1 developed and validated a risk index, based on 6 indicators predicting death or a severe cardiovascular complication for patients over the age of 50 years undergoing major, non-cardiac, elective surgery, with an expected inpatient stay of 2 or more days.
The purpose of the study was to apply the principles of Lees' study to our patient population to 1. Assess the quality of our care based on predicted and observed outcomes as developed by Lee and 2. Provide a data base to enable more accurate and relevant data about perioperative risk for our patients.
Following ethics committee approval, the charts of 750 patients (>50 years, elective, non-cardiac surgery, expected duration of admission of 2 or more days) were selected for review using data from the operating room management report(Operating Room Management Information Systems). Patients with one or more risk factors were selected by chart review by the authors. This review resulted in the analysis of the outcomes of 146 patients.
Result
| Number of Risk Factors | Number of Cases | Complications as per Lee et al |
| One only | 64 | NIL |
| Two only | 60 | 3 Infarcts [5%] 1 Death [1.6%] |
| Three or more [4 WITH 4 ] |
22 | 1 Pulmonary Oedema [5%] 1 Death[5%] |
The use of Lees' Index is a validated, reliable method of assessing the quality of outcome with respect to death and severe cardiovascular complications in patients with known risk factors, over the age of 50 years, undergoing elective, major non-cardiac surgery. It is a useful indicator of the quality of care in the total peri-operative process and assesses input as well as outcome.
The generation of local hospital data allows more accurate information to be given to patients about the risk of surgery.
Time of Presentation
Saturday 7 May 2005 - 1530-1700
References
