Definitions of the adapted Electronic Postoperative Morbidity Score (ePOMS) used for daily assessment of complications in a retrospective cohort of operated chronic subdural haematoma
Domain | Diagnostic criteria | Notes |
Respiratory | Need for supplementary oxygen | |
Cardiovascular | HR >100 SBP <100 Positive troponin test | |
Neurological | Need for 1:1 nursing observation Motor/Verbal Score worse than referral Focal neurology | Surrogate for hyperactive delirium Documented mismatch between left/right sided arm/leg strength at any stage |
Renal | Rise in creatinine to ≥1.5× baseline | Last recorded creatinine prior to surgery |
GI | Administered antiemetic | Defined by the following WHO ATC codes: a04*, a03fa01, r06ae03, n05ad08 |
Pain | Need for intravenous opioids or local anaesthetic infusion on a given day | Drugs identified by following WHO ATC codes: n02aa01, n02ab03, n01bb01 |
Recurrence† | Reoperation | ePOMS originally identifies severe wound infection by need for further surgery. In this context reoperation for the same procedure is being used to identify reaccumulation of cSDH |
Infection | Temperature ≥38°C Receiving antibiotics on a given day | Antibiotics defined by following WHO ATC codes: j01‡ |
Haematological | Transfused with blood product | Including red cells, platelets, FFP, cryoprecipitate |
If multiple potential criteria are listed then an individual is positive in that domain if any of these are met.
*Indicates additional criterion included in this variant of ePOMS from those previously published.
†In the original ePOMS this would correspond to the wound category.
‡Indicates that all drugs below this level of ATC code were included. A dictionary of relevant ATC codes is available in the online supplementary material.
FFP, fresh frozen plasma; GCS, Glasgow Coma Scale; GI, gastrointestinal; HR, heart rate; SBP, systolic blood pressure; WHO ATC, World Health Organization anatomical therapeutic chemical classification.