RT Journal Article
SR Electronic
T1 Integration of functional capacity to medically necessary, time-sensitive scoring system
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 921
OP 932
DO 10.15537/smj.2023.44.9.20230318
VO 44
IS 9
A1 Ahmet K. Koltka
A1 Müşerref B. Dinçer
A1 Mehmet Güzel
A1 Mukadder Orhan-Sungur
A1 Tülay Özkan-Seyhan
A1 Demet Altun
A1 Ali Fuat Kaan Gök
A1 Mehmet İlhan
YR 2023
UL http://smj.org.sa/content/44/9/921.abstract
AB Objectives: To evaluate 2 new modifications to medically necessary, time-sensitive (MeNTS) scoring systems integrating functional capacity assessment in estimating intensive care unit (ICU) requirements.Methods: This prospective observational study included patients undergoing elective surgeries between July 2021 and January 2022. The MeNTS scores and our 2 modified scores: MeNTS-METs (integrated Duke activity status index [DASI] as metabolic equivalents [METs]) and MeNTS-DASI-5Q (integrated modified DASI [M-DASI] as 5 questions) were calculated. The patients’ ICU requirements (group ICU+ and group ICU-), DASIs, patient-surgery-anesthesia characteristics, hospital stay lengths, rehospitalizations, postoperative complications, and mortality were recorded.Results: This study analyzed 718 patients. The MeNTS, MeNTS-METs, and MeNTS-DASI-5Q scores were higher in group ICU+ than in group ICU- (p<0.001). Group ICU+ had longer operation durations and hospital stay lengths (p<0.001), lower DASI scores (p<0.001), and greater hospital readmissions, postoperative complications, and mortality (p<0.001). The MeNTS-METs and MeNTS-DASI-5Q scores better predicted ICU requirement with areas under the receiver operating characteristic curve (AUC) of 0.806 and 0.804, than the original MeNTS (AUC=0.782).Conclusion: The 5-questionnaire M-DASI is easy to calculate and, when added to a triage score, is as reliable as the original DASI for predicting postoperative ICU requirements.