Journal
ANESTHESIOLOGY
Volume 117, Issue 3, Pages 475-486Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ALN.0b013e318267ef31
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Funding
- Merck & Co., Inc., North Wales, Pennsylvania
- MGI Pharma
- Eisai (Woodcliff Lake, New Jersey)
- Merck Co.
- Schering-Plough
- Baxter
- Helsinn
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Background: About one in four patients suffers from postoperative nausea and vomiting. Fortunately, risk scores have been developed to better manage this outcome in hospitalized paplied to a development dataset and the area under the receiver operating characteristic curve was calculated in a validation dataset. Results: The overall incidence of PDNV was 37%. Logistic regression analysis of the development dataset (n = 1,913) identified five independent predictors (odds ratio; 95% CI): female gender (1.54; 1.22 to 1.94), age less than 50 yr (2.17; 1.75 to 2.69), history of nausea and/or vomiting after previous anesthesia (1.50; 1.19 to 1.88), opioid administration in the postanesthesia care unit (1.93; 1.53 to 2.43), and nausea in the postanesthesia care unit (3.14; 2.44-4.04). In the validation dataset (n = 257), zero, one, two, three, four, and five of these factors were associated with a PDNV incidence of 7%, 20%, 28%, 53%, 60%, and 89%, respectively, and an area under the receiver operating characteristic curve of 0.72 (0.69 to 0.73). Conclusions: PDNV affects a substantial number of patients after ambulatory surgery. We developed and validated a simplified risk score to identify patients who would benefit from long-acting prophylactic antiemetics at discharge from the ambulatory care center.
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