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Model identifies risk of serious complications following surgery

Press releases may be edited for formatting or style | February 26, 2021 Operating Room
PHILADELPHIA - Heart attack, kidney failure, stroke. These are just a few of the life-threatening complications that patients are at risk for following surgery. Now Jefferson researchers have developed an easy-to-use, web-based tool that predicts the risk of post-surgical complications such as kidney failure and stroke. The model may help medical professionals put preventive measures in place before the need for emergency intervention.

"We need to be able to assess the risk of life-threatening, post-surgical complications so we can then come up with individualized ways to reduce those complications," says Sang Woo, MD, a clinical associate professor of medicine at Thomas Jefferson University who led the new research.

The need for better predictive risk models became clear to Dr. Woo after a patient suffered kidney failure following surgery and required medical intervention like dialysis. Another patient suffered a stroke following surgery to treat a fractured hip and suddenly needed emergency brain surgery.

"Seeing how much suffering those patients had gone through, I wanted to figure out what we could have done differently to prevent these life-threatening complications," Dr. Woo says.

Risk calculators that doctors currently rely on mainly assess for cardiac risks, such as heart attack or cardiac arrest. They do not provide risk assessment of other major complications like stroke, and doctors have not really paid much attention to risk assessment for kidney failure, Dr. Woo says.

"We wanted to assist doctors to be able to assess the risk of stroke, in addition to traditional risks," he says.

To develop a predictive model that was accurate and easy for clinicians to use, Dr. Woo drew on expertise in analyzing big data sets and machine learning, and collaborated with a multidisciplinary Jefferson research team including a surgeon, cardiologist, nephrologists and hospitalists.

"Often times we do the research and publish a research paper that is too complex to translate to the bedside," Dr. Woo says. "My goal from the beginning was to come up with a new model that is very practical and useful and that can be incorporated into routine patient care."

Now, in two recent studies, Dr. Woo and colleagues show that the model effectively predicts the risk of life-threatening, post-surgical complications.

In a study published online December 29, 2020 in the research journal Kidney360, Dr. Woo and colleagues developed a model to assess a patient's risk of developing acute kidney injury (AKI) following surgery. AKI is a serious medical issue. More than a third of patients that required dialysis following cardiac surgery died for example.

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