Development and validation of a risk score to predict the probability of postoperative vomiting in pediatric patients: the VPOP score. Issue 9 (14th May 2014)

• Record Type: Journal Article
• Authors: Bourdaud, Nathalie; Devys, Jean‐Michel; Bientz, Jocelyne; Lejus, Corinne; Hebrard, Anne; Tirel, Olivier; Lecoutre, Damien; Sabourdin, Nada; Nivoche, Yves; Baujard, Catherine; Orliaguet, Gilles A.; Lerman, Jerrold
• Is Part Of: Paediatric anaesthesia. Volume 24:Issue 9(2014)
• Page Start: 945
• Page End: 952
• Publication Date: 2014-05-14
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12428
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12428-abs-0001"> <title>Summary</title> <sec id="pan12428-sec-0001" sec-type="section"> <title>Background</title> <p>Few data are available in the literature on risk factors for postoperative vomiting (POV) in children.</p> </sec> <sec id="pan12428-sec-0002" sec-type="section"> <title>Objective</title> <p>The aim of the study was to establish independent risk factors for POV and to construct a pediatric specific risk score to predict POV in children.</p> </sec> <sec id="pan12428-sec-0003" sec-type="section"> <title>Methods</title> <p>Characteristics of 2392 children operated under general anesthesia were recorded. The dataset was randomly split into an evaluation set (<italic>n</italic> = 1761), analyzed with a multivariate analysis including logistic regression and backward stepwise procedure, and a validation set (<italic>n</italic> = 450), used to confirm the accuracy of prediction using the area under the receiver operating characteristic curve (ROC<sub>AUC</sub>), to optimize sensitivity and specificity.</p> </sec> <sec id="pan12428-sec-0004" sec-type="section"> <title>Results</title> <p>The overall incidence of POV was 24.1%. Five independent risk factors were identified: stratified age (>3 and <6 or >13 years: adjusted OR 2.46 [95% CI 1.75–3.45]; ≥6 and ≤13 years: aOR 3.09 [95% CI 2.23–4.29]), duration of anesthesia (aOR 1.44 [95% IC 1.06–1.96]), surgery at risk (aOR 2.13 [95% IC 1.49–3.06]), predisposition to POV (aOR 1.81 [95% CI 1.43–2.31]), and multiple opioids doses (aOR 2.76 [95% CI 2.06–3.70], <italic>P</italic> < 0.001). A simplified score was created, ranging from 0 to 6 points. Respective incidences of POV were 5%, 6%, 13%, 21%, 36%, 48%, and 52% when the risk score ranged from 0 to 6. The model yielded a ROC<sub>AUC</sub> of 0.73 [95% CI 0.67–0.78] when applied to the validation dataset.</p> </sec> <sec id="pan12428-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Independent risk factors for POV were identified and used to create a new score to predict which children are at high risk of POV.</p> </sec> </abstract>