title: Basic Features and Clinical Applicability of 'Preliminary Universal Surgical Invasiveness Score' (pUSIS): A Multi-Centre Pilot Study.
abstract: OBJECTIVE
  There is still a lack of a universally applicable and comprehensive scoring system for documenting the invasiveness of surgical procedures. The proposed preliminary 'Universal Surgical Invasiveness Score' (pUSIS) is intended to fill this gap.
  
  
  METHODS
  We used the recently developed pUSIS to obtain values from 8 types of surgery and 80 individual interventions. The results were analysed using descriptive statistical methods. The degree of difficulty on a scale from 0 (very easy) to 10 (extremely difficult) and time expenditures for assessing pUSIS were documented.
  
  
  RESULTS
  Individual pUSIS values ranged from 8 in a laparoscopic cholecystectomy case to 36 in a total hip replacement case. The lowest median pUSIS value of 11.5 was found for laparoscopic cholecystectomy and the highest value of 24.5 was found for open thoracic surgery. The correlation between pUSIS values and the duration of surgery resulted in a tight linear regression (R2=0.6419). The lowest mean (±SD) difficulty level to obtain pUSIS values was 1.6±0.6 for sleeve gastrectomy and the highest one was 2.9±0.6 for knee replacement. The duration to finalise the calculations was 4.1±1.1 min for video-assisted thoracoscopy (VATS) and 9.4±1.3 min for sleeve gastrectomy.
  
  
  CONCLUSIONS
  We concluded that pUSIS has the potential to be a useful, simply obtainable and universal assessment tool for quantification of the magnitude and invasiveness of individual surgical operations and can serve as a means to quantify surgical interventions for outcome research and evaluate surgical performance.
authors.affiliation: Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Biro
authors.affiliation: Department of Anesthesiology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Sermeus
authors.affiliation: Department for Anesthesia and Intensive Care, School of Medicine, University of Nis, Nis, Serbia.
authors.forename: Radmilo
authors.initials: R
authors.lastname: Jankovic
authors.affiliation: Department for Anesthesia and Intensive Care, School of Medicine, University of Nis, Nis, Serbia.
authors.forename: Nenad
authors.initials: N
authors.lastname: Savić
authors.affiliation: Emergency County Hospital Cluj-Napoca, Orthopedic and Trauma Clinic, Anaesthesia and Intensive Care Department, Cluj-Napoca, Romania.
authors.forename: Adela Hilda
authors.initials: AH
authors.lastname: Onuţu
authors.affiliation: Department of Anesthesia and Intensive Care I, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Outcomes Research Consortium, Cleveland, Ohio.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ionescu
authors.affiliation: Department of Anesthesia, Ponderas Hospital, Centre of Excellence for Bariatric and Metabolic Surgery, University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Godoroja
authors.affiliation: Department of Anesthesiology and Critical Care, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gurman
keywords: Surgical invasiveness; outcome; score; surgical risk