A Multidimensional Approach of Surgical Mortality Assessment and Stratification (Smatt Score)

Figures

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  Figure 1. Forrest plot derived from the logistic multivariable model. The estimated odds ratios (OR) are shown as dots, and the 95% confidence intervals as whiskers. The reference category is shown with a dot only on the no effect line (OR = 1). Whiskers to the right of this line correspond to an increased risk of death, with respect to the reference category; whiskers to the left, correspond to a lesser risk than the reference category; whiskers crossing the no effect line denote lack of statistical significance.

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  Figure 2. SMATT calculation and probability of death is obtained by the implementation of individual data in the app. Two hypothetical scenarios are shown, with the SMATT score calculated through the app. The derived probability of perioperative death is 0% in panel A (SMATT = 36); 3% (SMATT = 54) in panel B and 83% (SMATT = 88) in Panel C. Panel A). The patient is a 71-years-old woman, with a prior history of ischemic cardiomyopathy and COPD, chronic pancreatitis, peptic ulcer. She was hospitalized for a femoral fracture. Panel B). The patient is a 45-years-old woman, underweight, with a prior history of chronic gastritis, breast cancer, peripheral nervous system disease, osteoarthritis. She has an ASA score 3, she was hospitalized for an elective hysteroannessiectomy. Panel C). The patient is a 54-years-old man, normo-overweight, with a prior history of ischemic cardiomyopathy and COPD, cirrhosis, esophageal varices, AIDS, colon cancer, hyperparathyroidism. He has an ASA score 4, he was hospitalized for an emergency laparotomy for an intestinal obstruction.