Evaluation of the McPeek postoperative outcome score in three trials.
BACKGROUND
Postoperative outcome of patients is determined by recovery characteristics and self-reported quality of life. The first can be assessed with the McPeek score which values three aspects of recovery: mortality, postoperative critical care and duration of hospitalization.


METHODS
We calculated the McPeek score of 669 patients in three trials: (1) colorectal cancer surgery, (2) antihistamine/volume loading in various operations, and (3) cholecystectomy. Beforehand, the average of intensive care unit treatment and duration of hospitalization were determined for the different operations to define McPeek score points. The score was tested on reliability, validity, and sensitivity. In addition, clinical applicability was assessed in a survey.


RESULTS
The score was reliable with similarly distributed score points in the three trials at different institutions. Inter-rater reliability was high (97% overlap). Validity was proven by moderate high correlation to convergent criteria such as complications (trial I to III r=0.43, r=0.38, r=0.60), preoperative American Society of Anesthesiologists class (ASA) (r=0.24, r=0.28, r=0.57), and age (r=0.23, r=0.32, r=0.31). The score was different between patients with and without neoplasms (P<0.001, trial II) and between elective or emergency patients (P<0.001, trial III). In a survey, investigators reported that the score was easy to assess and more comprehensive than four other scores.


CONCLUSIONS
The McPeek score values the postoperative outcome on a nonlinear scale. A priori, the average duration of hospitalization and critical care for a specific operation has to be defined. Our validation suggests that it is a reliable, valid, sensitive, and practical instrument for outcome analysis after anesthesia and surgery.
Bauhofer
Artur
A
Institute of Theoretical Surgery, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany. a-bauhofer@web.de
Lorenz
Wilfried
W
Koller
Michael
M
Menke
Henrik
H
Sessler
Daniel I
DI
Sitter
Helmut
H
Celik
Ilhan
I
Nies
Christoph
C
Wulf
Hinnerk
H
Torossian
Alexander
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume; D002763:Cholecystectomy / Q000401:mortality; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D003422:Critical Care / Q000706:statistics & numerical data; D003625:Data Collection / Q000706:statistics & numerical data; D004311:Double-Blind Method; D005240:Feasibility Studies; D005260:Female; D006633:Histamine Antagonists / Q000008:administration & dosage*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results
D006633:Histamine Antagonists