Why the study?
The study aimed to develop a scoring system to predict postoperative oxygen requirements, enhance clinical decision-making, reduce unnecessary oxygen use, and improve the efficiency of postoperative respiratory care.
Does the WHO2SAFE score predict postoperative oxygen requirement at PACU discharge in patients undergoing elective non-cardiac surgery?
Does the WHO2SAFE score predict postoperative oxygen requirement at PACU discharge in patients undergoing elective non-cardiac surgery?
The WHO2SAFE score provides a practical tool for predicting the need for supplemental oxygen at PACU discharge, helping to identify high-risk patients and minimize unnecessary oxygen use.
May support targeted oxygen use after elective surgery; leaves open prospective validation before practice change.
Background: This study aimed to develop a scoring system that predicts postoperative oxygen requirements, enhances clinical decision-making, reduces unnecessary oxygen use, and improves the efficiency of postoperative respiratory care. Methods: This retrospective study included patients who underwent elective non-cardiac surgery with general anesthesia between 1 January 2018 and 31 December 2022. The outcome of the study was the postoperative oxygen requirement at PACU discharge. Predictors with significance were used to create a scoring system. Results: Among the 42,378 cases, 14.9% required supplemental oxygen at PACU discharge. The WHO2SAFE score, which ranges from 0 to 15, incorporates eight independent risk factors, given in the mnemonic WHO2SAFE: intraoperative wheezing, intraoperative hypotension, obesity, operative time ≥ 180 min, sleep apnea, ASA classification ≥ 3, female, and elderly. Conclusions: The WHO2SAFE score provides a practical tool for predicting the need for supplemental oxygen at PACU discharge via the web, facilitating early intervention and efficient resource utilization. A cutoff score of 6 facilitates clinicians to identify high-risk patients who benefit from close observation while minimizing unnecessary oxygen use in low-risk individuals.
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Sungworawongpana et al. (2025) studied this question.
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