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Assessing the applicability of scoring systems for predicting postoperative nausea and vomiting
Author(s) -
Van Den Bosch J. E.,
Kalkman C. J.,
Vergouwe Y.,
Van Klei W. A.,
Bonsel G. J.,
Grobbee D. E.,
Moons K. G. M.
Publication year - 2005
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04121.x
Subject(s) - nausea , vomiting , medicine , scoring system , receiver operating characteristic , postoperative nausea and vomiting , predictive value , calibration , predictive value of tests , anesthesia , surgery , statistics , mathematics
Summary We have validated two scoring systems for predicting postoperative nausea and vomiting, derived by Apfel et al . and Koivuranta et al. from 1388 adult inpatients undergoing a wide range of surgical procedures. The predictive accuracy of the scoring systems was evaluated in terms of the ability to discriminate between patients with and without postoperative nausea and vomiting (discrimination) and agreement between observed and predicted outcomes (calibration). Discrimination and calibration were less than expected based on previous reports, with both scoring systems providing risk predictions that were too extreme. The area under the ROC curve was 0.63 for Apfel et al .'s scoring system and 0.66 for Koivuranta et al .'s scoring system. Neither of the scoring systems provided a risk threshold for administering anti‐emetic prophylaxis that yielded satisfying results in terms of predictive values, sensitivity and specificity. Hence, in their original forms, the scoring systems do not guarantee accurate prediction of the risk of postoperative nausea and vomiting in other patient populations. Koivuranta et al .'s scoring system appears to be more robust across different populations.