Skip to main content

Advertisement

Table 1 The Cardiac Post-Operative Morbidity Score (C-POMS) (as reported in Sanders et al. 2012)

From: Predictors of total morbidity burden on days 3, 5 and 8 after cardiac surgery

Morbidity type C-POMS criteria
Pulmonary Presence of one or more of the following: ▪ New requirement for oxygen or respiratory support (including nebuliser therapy or request for chest physiotherapy on or after D5) ▪ Pleural effusion requiring drainage
Infectious Presence of one or more of the following: ▪ Currently on antibiotics ▪ Has had a temperature of >38 °C in the last 24 h ▪ Has a white cell count/CRP level requiring in-hospital review or treatment
Renal Presence of one or more of the following: ▪ Presence of decreased urine output requiring intervention (including IV furosemide) ▪ Increased serum creatinine (>30% from pre-operative level) ▪ Urinary catheter in situ ▪ New urinary incontinence ▪ Serum potassium abnormalities requiring treatment
Gastrointestinal Presence of one or more of the following: ▪ Unable to tolerate an enteral diet for any reason including nausea, vomiting and abdominal distension ▪ Nasogastric tube ▪ Diagnosis of a gastrointestinal bleed ▪ Diarrhoea
Cardiovascular Presence of one or more of the following: ▪ The use of inotropic therapy for any cardiovascular cause ▪ Pacing wires (on or after D5) and/or requiring temporary or new permanent pacing ▪ Diagnostic tests or therapy within the last 24 h for any of the following: (1) new MI or ischaemia, (2) hypotension (requiring fluid therapy, pharmacological therapy or omission of pharmacological therapy, (3) atrial or ventricular arrhythmias, (4) cardiogenic pulmonary oedema, thrombotic event (requiring anticoagulation), (5) hypertension (pharmacological therapy or omission of pharmacological therapy)
Neurological New neurological deficit (including confusion, delirium, coma, lack of coordination, drowsy/slow to wake, poor swallow, blurred vision, sedated, changing loss of consciousness)
Haematological Presence of one or more of the following: ▪ Untherapeutic INR requiring pharmacological therapy or omission of pharmacological therapy ▪ Requirement for any of the following within the last 24 h: packed erythrocytes, platelets, fresh-frozen plasma, or cryoprecipitate
Wound Presence of one or more of the following: ▪ Wound dehiscence requiring surgical exploration or drainage of pus from the operation wound with or without isolation of organisms ▪ Chest drains ▪ Wound pain significant enough to require continuing or escalating analgesic intervention
Pain Postoperative pain significant enough to require parenteral opioids and/or continuing or additional analgesia
Endocrine New or additional requirements for blood sugar management
Electrolyte Electrolyte (including sodium, urea, phosphate) imbalance requiring oral or intravenous intervention (not including potassium as included in renal category)
Review Remaining in hospital for further review, investigation and/or procedure
Assisted ambulation A new or escalated post-operative requirement for mobility assistance (including wheelchair, crutches, zimmer frame, walking sticks or assistance)
  1. CRP C-reactive protein, IV intravenous, MI myocardial infarction, INR international normalised ratio, OPA out-patient appointment, OT occupational therapy