- Medically necessary, time-sensitive scoring system.5
| Variables | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| Procedure factors | |||||
| OR time (min) | <30 | 31-60 | 61-120 | 121-180 | ≥181 |
| Estimated LOS | Outpatient | <23 h | 24-48 h | 2-3 d | ≥4 d |
| Postoperative ICU need (%) | Very unlikely | <5 | 5-10 | 11-25 | >25 |
| Anticipated blood loss (cc) | <100 | 100-250 | 250-500 | 500-750 | ≥751 |
| Surgical team size (n) | 1 | 2 | 3 | 4 | 5 |
| Intubation probability (%) | ≤1 | 1-5 | 6-10 | 11-25 | >25 |
| Surgical site | None | Abdomino-pelvic MIS | Abdomino-pelvic open surgery, infraumbilical | Abdomino-pelvic open surgery, supraumbilical | OHNS/upper GI/thoracic |
| Disease factors | |||||
| Nonoperative treatment option effectiveness | None available | Available, <40% as effective as surgery | Available, 40-60% as effective as surgery | Available, 61-95% as effective as surgery | Available, equally effective |
| Nonoperative treatment option resource/exposure risk | Significantlyworse/not applicable | Somewhat worse | Equivalent | Somewhat better | Significantly better |
| Impact of 2-wk delay in disease outcome | Significantly worse | Worse | Moderately worse | Slightly worse | No worse |
| Impact of 2-wk delay in surgical difficulty/risk | Significantly worse | Worse | Moderately worse | Slightly worse | No worse |
| Impact of 6-wk delay in disease outcome | Significantly worse | Worse | Moderately worse | Slightly worse | No worse |
| Impact of 6-wk delay in surgical difficulty/risk | Significantly worse | Worse | Moderately worse | Slightly worse | No worse |
| Patient factors | |||||
| Age, years | <20 | 21-40 | 41-50 | 51-65 | >65 |
| Lung disease (asthma, COPD, CF) | None | - | - | Minimal (rare inhaler) | >Minimal |
| Obstructive sleep apnea | Not present | - | - | Mild/moderate (no CPAP) | On CPAP |
| CV disease (HTN, CHF, and CAD) | None | Minimal (no meds) | Mild (one med) | Moderate (2 meds) | Severe (≥3 meds) |
| Diabetes | None | - | Mild (no meds) | Moderate (PO meds only) | >Moderate (insulin) |
| Immuno-compromised* | No | - | - | Moderate | Severe |
| ILI symptoms† | None (asymptomatic) | - | - | - | Yes |
| Exposure to a COVID-19 person in past 14 days | No | Probably not | Possibly | Probably | Yes |
↵* Hematologic malignancy, stem cell transplant, solid organ transplant, active/recent cytotoxic chemotherapy, anti-TNFa or other immunosuppressants, >20 mg prednisone equivalent/day, congenital immunodeficiency, hypogammaglobulinemia on intravenous immunoglobulin, and AIDS.
↵† Such as fever, cough, sore throat, body aches, and diarrhea.
OR: operating room, min: minutes, LOS: length of stay, h: hours, d: days, ICU: intensive care unit, MIS: minimally invasive surgery, OHNS: otolaryngology, head & neck surgery, GI: gastrointestinal, wk: week, COPD: chronic obstructive pulmonary disease, CF: cystic fibrosis, CPAP: continuous positive airway pressure, CV: cardiovascular, HTN: hypertension, CHF: congestive heart failure, CAD: coronary artery disease, meds: medication, PO: by mouth, ILI: influenza-like illness, COVID-19: coronavirus disease-19