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Observational Study
. 2023 Sep;44(9):921-932.
doi: 10.15537/smj.2023.44.9.20230318.

Integration of functional capacity to medically necessary, time-sensitive scoring system: A prospective observational study

Ahmet K Koltka  1 , Müşerref B Dinçer  1 , Mehmet Güzel  1 , Mukadder Orhan-Sungur  1 , Tülay Özkan-Seyhan, Demet Altun  1 , Ali Fuat Kaan Gök  1 , Mehmet İlhan  1
Affiliations
Observational Study

Integration of functional capacity to medically necessary, time-sensitive scoring system: A prospective observational study

Ahmet K Koltka et al. Saudi Med J. 2023 Sep.

Abstract

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.

Keywords: elective surgical procedures; intensive care units; metabolic equivalent; triage.

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Figures

Figure 1
Figure 1
- Flow diagram.
Figure 2
Figure 2
- Receiver operating characteristic (ROC) curve determining the carrying out of MeNTS, MeNTS-METs, and MeNTS-DASI-5Q score for predicting ICU requirement. Area under the curve (AUC)=0.782 (95% CI: [0.742-0.822]) for MeNTS score. Area under the curve=0.806 (95% CI: [0.769-0.843]) for MeNTS-METs, and AUC=0.804 (95% CI [0.766-0.841]) for MeNTS-DASI-5Q.
See this image and copyright information in PMC

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