P-POSSUM Score and Length of Stay

Study Overview
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Brief Summary
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P-POSSUM score had a predictive power of >80% to predict the length of stay of kidney transplant recipients

Official Title
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Correlation Between P-POSSUM Score and Length of Stay in Kidney Transplant Recipients

Conditions
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Length of Stay

Intervention / Treatment
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* Other: Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) score


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects are medical record of recipients who underwent kidney transplant Exclusion Criteria: Medical record was incomplete Patients who died during surgery or before the patient was discharged.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Not prolonged length of stay<br>Living donor patients who had ≤ 6 days length of stay after laparoscopic nephrectomy procedure | Other: Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) score<br>* P-POSSUM score's variables are divided into physiological parameters (age, cardiac, respiratory, ECG, systolic blood pressure, pulse rate, haemoglobin, leukocyte count, urea, sodium plasma, potassium plasma, and GCS) and operative parameters (operation type, number of procedures, operative blood loss, peritoneal contamination, malignancy status, CEPOD).<br>|
| Prolonged length of stay<br>Living donor patients who had > 6 days length of stay after laparoscopic nephrectomy procedure | Other: Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) score<br>* P-POSSUM score's variables are divided into physiological parameters (age, cardiac, respiratory, ECG, systolic blood pressure, pulse rate, haemoglobin, leukocyte count, urea, sodium plasma, potassium plasma, and GCS) and operative parameters (operation type, number of procedures, operative blood loss, peritoneal contamination, malignancy status, CEPOD).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between each variable of P-POSSUM and length of stay | Correlation between 18 variables (12 variables as physical parameters and 6 variables as operative parameters) and length of stay | 1 day before surgery until discharged from hospital, up to 30 days | 
| P-POSSUM score Discrimination | P-POSSUM score ability to discriminate length of stay based on variable scores: physical parameters and operative parameters | 1 day before surgery until discharged from hospital, up to 30 days | 
| P-POSSUM score Calibration | P-POSSUM score cutoff to predict length of stay based on variable scores: physical parameters and operative parameters | 1 day before surgery until discharged from hospital, up to 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient's length of stay post kidney transplantation | Patient's length of stay post kidney transplantation | From post surgery until discharged from hospital, up to 30 days | 
| P-POSSUM score (physical parameters): Age | The score for Age variable cut-off: point for <61 years point for 61-71 years 4 point >71 years | 1 day before surgery | 
| P-POSSUM score (physical parameters): Heart disease | The score for heart disease variable cut-off: point for no heart failure point for diuretic, digoxin or angina/hypertension medicine usage 4 point for peripheral edema, warfarin, or borderline cardiomegaly on chest X-ray (CXR) | 1 day before surgery | 
| P-POSSUM score (physical parameters): Lung disease | The score for lung disease variable cut-off: point for no dyspnea points for exertional dyspnea or mild COPD on CXR 4 points for limiting dyspnea or moderate COPD on CXR 8 points for dyspnea at rest or fibrosis/consolidation on CXR | 1 day before surgery | 
| P-POSSUM score (physical parameters): ECG abnormality | The score for ECG abnormality variable cut-off: 1 point for normal ECG 4 points for atrial fibrillation (HR 60-90 8 points for 5 ectopic beats/min, Q waves or ST/T wave change | 1 day before surgery | 
| P-POSSUM score (physical parameters): Systolic blood pressure | The score for systolic blood pressure variable cut-off: point for 110 - 130 mmHg points for 100-109 mmHg or 131-170 mmHg 4 points for > 170 mmHg or 90-99 mmHg 8 points for < 90 mmHg | 1 day before surgery | 
| P-POSSUM score (physical parameters): Pulse rate | The score for pulse rate variable cut-off: point for 50-80 beats per minute (bpm) points for 40-59 bpm or 81-100 bpm 4 points for 101-120 bpm 8 points for > 121 bpm or < 40 bpm | 1 day before surgery | 
| P-POSSUM score (physical parameters): Hemoglobin | The score for hemoglobin variable cut-off: point for 13-16 g/dL points for 11.5-12.9 or 16.1-17 d/dL 4 points for 10-11.4 or 17.1-18 g/dL 8 points for <10 or >18 g/dL | 1 day before surgery | 
| P-POSSUM score (physical parameters): Leukocyte count | The score for leukocyte count variable cut-off: point for 4.000-10.000/mm3 points for 10.100-20.000 atau 3.100-4.000/mm3 4 points for >20.000 atau <3.000/mm3 | 1 day before surgery | 
| P-POSSUM score (physical parameters): Plasma potassium concentration | The score for plasma potassium concentration variable cut-off: point for 3.5-5 mmol/L points for 3.2-3.4 or 5.1-5.3 mmol/L 4 points for 2.9-3.1 or 5.4-5.9 mmol/L 8 points for <2.9 or >5.9 mmol/L | 1 day before surgery | 
| P-POSSUM score (physical parameters): Plasma sodium concentration | The score for plasma sodium concentration variable cut-off: point for >135 mmol/L points for 131-135 mmol/L 4 points for 126-130 mmol/L 8 points for <126 mmol/L | 1 day before surgery | 
| P-POSSUM score (operative parameters): Number of procedures | The score for number of procedures variable cut-off: 1 point for one 4 points for two 8 points for more than two | 1 day before surgery | 
| P-POSSUM score (operative parameters): Intraoperative blood loss | The score for intraoperative blood loss variable cut-off: point for <100 mL points for 101-500 mL 4 points for 501-999 mL 8 points for > 999 mL | Intraoperative | 
| P-POSSUM score (operative parameters): Peritoneal contamination/soiling | The score for peritoneal contamination/soiling variable cut-off: point for none points for minor (serous fluid) 4 points for local pus 8 points for free bowel content, pus or blood | Intraoperative | 
| P-POSSUM score (operative parameters): Presence of malignancy | The score for presence of malignancy variable cut-off: point for none points for primary only 4 points for nodal metastases 8 points for distant metastases | 1 day before surgery | 
| P-POSSUM score (operative parameters): Mode of surgery | The score for mode of surgery variable cut-off: 1 point for elective 4 points for emergency resuscitation of > 2 hours possible operation < 24 hours after admission 8 points for emergency (immediate surgery < 2 hours needed) | 1 day before surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mortality, morbidity, length of stay, kidney, transplant