An improved model for predicting postoperative nausea and vomiting in ambulatory surgery patients using physician-modifiable risk factors.

Journal of the American Medical Informatics Association : JAMIA
Pankaj SarinLucila Ohno-Machado

Abstract

Postoperative nausea and vomiting (PONV) is a frequent complication in patients undergoing ambulatory surgery, with an incidence of 20%-65%. A predictive model can be utilized for decision support and feedback for practitioner practice improvement. The goal of this study was to develop a better model to predict the patient's risk for PONV by incorporating both non-modifiable patient characteristics and modifiable practitioner-specific anesthetic practices. Data on 2505 ambulatory surgery cases were prospectively collected at an academic center. Sixteen patient-related, surgical, and anesthetic predictors were used to develop a logistic regression model. The experimental model (EM) was compared against the original Apfel model (OAM), refitted Apfel model (RAM), simplified Apfel risk score (SARS), and refitted Sinclair model (RSM) by examining the discriminating power calculated using area under the curve (AUC) and by examining calibration curves. The EM contained 11 input variables. The AUC was 0.738 for the EM, 0.620 for the OAM, 0.629 for the RAM, 0.626 for the SARS, and 0.711 for the RSM. Pair-wise discrimination comparison of models showed statistically significant differences (p<0.05) in AUC between the EM and all other mod...Continue Reading

References

Mar 1, 1984·Canadian Anaesthetists' Society Journal·M G Palazzo, L Strunin
Jan 1, 1982·American Journal of Epidemiology·S Lemeshow, D W Hosmer
Jan 1, 1994·Anesthesia and Analgesia·M M CohenW A Tweed
May 15, 1997·Statistics in Medicine·D W HosmerS Lemeshow
May 1, 1997·Anaesthesia·M KoivurantaS Alahuhta
Mar 27, 1999·Journal of the American Medical Informatics Association : JAMIA·R N ShiffmanG J Corb
Jul 9, 1999·Journal of Clinical Anesthesia·F J OverdykJ Marcell
Dec 10, 1999·Anesthesia and Analgesia·F Chung, G Mezei
Feb 13, 2001·Anesthesia and Analgesia·T GanD A Lubarsky
Sep 28, 2001·British Journal of Anaesthesia·C C ApfelN Roewer
Mar 9, 2002·British Journal of Anaesthesia·C C ApfelN Roewer
Sep 10, 2002·The Clinical Journal of Pain·Yuan-Yi ChiaLok-Hi Chow
Jun 24, 2003·Anesthesia and Analgesia·Tong J GanUNKNOWN Department of Anesthesiology, Duke University Medical Center
Apr 6, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Sébastien PierreChristian C Apfel
Apr 6, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ashraf S Habib, Tong J Gan
Jun 11, 2004·The New England Journal of Medicine·Christian C ApfelUNKNOWN IMPACT Investigators
May 24, 2006·Anesthesia and Analgesia·Tong J Gan

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Citations

Apr 3, 2016·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Christopher A Smith, Lisa Ruth-Sahd
Jan 13, 2017·Anesthesia and Analgesia·Rodney A GabrielLucila Ohno-Machado
Nov 6, 2014·The Clinical Journal of Pain·Jan Odom-ForrenChristian C Apfel
Aug 11, 2015·Korean journal of anesthesiology·Ann Misun YounYoon-Hee Kim
Jan 15, 2021·The Spine Journal : Official Journal of the North American Spine Society·Bertrand DebonoHans D de Boer
Aug 12, 2020·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Sinem Gecit, Turkan Ozbayir
Dec 9, 2020·Best Practice & Research. Clinical Anaesthesiology·Mikhail Dziadzko, Frédéric Aubrun

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