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Scoring System Helps Guide Surgical Care During COVID-19

Twenty-one factors that were significant contributors to procedure triage and prioritization identified

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WEDNESDAY, April 22, 2020 (HealthDay News) -- A scoring system for medically necessary time-sensitive (MeNTS) procedures can facilitate decision making and triage in the setting of COVID-19, according to a study published online April 9 in the Journal of the American College of Surgeons.

Vivek N. Prachand, M.D., from the University of Chicago Medicine and Biological Sciences, and colleagues describe a scoring system that integrates factors such as resource limitations and COVID-19 transmission risk to providers and patients to guide triage for MeNTS procedures and weigh individual patient risks.

The researchers identified 21 factors that were significant contributors to MeNTS procedure triage and prioritization in the context of COVID-19 within three general categories: procedure, disease, and patient. The resulting cumulative MeNTS score was 21 to 105 points. A higher score is associated with poorer perioperative patient outcome, increased risk for COVID-19 transmission, and/or increased hospital resource utilization. Based on the immediately anticipated conditions and resources at each institution, an upper threshold MeNTS score can be designated by surgical and perioperative leadership, given the need to maintain operating room capacity for trauma, emergency, and highly urgent cases. Performing a procedure for which the score exceeds this threshold is unlikely to be justifiable given the associated risks. A lower-threshold MeNTS score can be assigned, below which it would be reasonable to proceed with MeNTS procedures.

"The scoring system can also be used to facilitate organization and prioritization of the large backlog of MeNTS cases that will await completion when the pandemic begins to subside," the authors write.

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