A Prospective Evaluation of the POVOC Score for the Prediction of Postoperative Vomiting in Children

In Brief BACKGROUND: A score to predict postoperative vomiting (PV) in children (POVOC score) has recently been published but has not yet undergone an external validation. METHODS: We studied 673 patients (age 0–16 yr) undergoing a variety of surgical procedures (but excluding strabismus surgery, one of the risk factors according to the POVOC score) using standardized anesthesia techniques without administering antiemetics. The patients were prospectively screened for PV in the postoperative period and these incidences were compared with the predicted risk for PV according to the POVOC score. The POVOC score was evaluated with respect to its ease of use, discrimination, and calibration. RESULTS: Complete data to predict the risk for PV could be obtained in 95% of patients. The actual observed incidences of PV were 3.4, 11.6, 28.2, and 42.3% for the presence of 0, 1, 2, or 3 risk factors, resulting in a regression line with a slope of 0.78 and an offset of 2.37. The area under the receiver operating characteristic curve was 0.72 (95% CI: 0.68–0.76). CONCLUSIONS: Using the POVOC score, PV in pediatric patients can be predicted with sufficient accuracy comparable to the results in adult patients, even if one of the risk factors is not applicable. IMPLICATIONS: This evaluation trial suggests that the POVOC score for the prediction of postoperative vomiting (PV) in children allows for the risk for PV to be estimated in various patient populations and in different settings with acceptable accuracy.