Evaluation of a psychological risk-score for the prediction of outcome in anaesthesia and intensive care medicine

GRAZ-01-22 Introduction: Somatic scoring systems for the evaluation of severity of illness are commonly used in anaesthesia and intensive care medicine [1]. Although the momentary psychophysiological condition is known to be very important in the context of perioperative stress response, no psychological risk profile is known for the prediction of outcome in anaesthesia and intensive care medicine. The aim of these studies was to evaluate such a psychological scoring system on the basis of biopsychological stress theory. Methods: By using Configural-Frequency-Analysis, a non-parametric statistical method to define types of persons by a configuration of attributes, healthy volunteers (n = 1300) and surgical patients (n = 900) were studied. Psychometric measurements of coping styles, state of recovery and mood were made by well-established inventories. After defining types on the basis of psychometric measurements an evaluation of outcome was made in the groups of surgical patients. Results: The results show that in order to classify patients regarding high or low psychological risk information of habitual coping styles, state of recovery and mood-state are needed. Dependent on the psychological risk, profile length of ICU-stay varies. Low-risk patients left the ICU 1 day earlier. In addition this group of patients received a smaller amount of packed red blood cells after aortocoronary bypass grafting. There were significant differences in the sympatho-adrenergic stress response compared to high-risk patients. The psychological risk-score is independent from somatic risk factors. Conclusions: The psychophysiological condition is important for perioperative outcome. It leaves additional information to somatic scoring systems.