Use of MeNTS, Frailty and Symptom Scales for selecting surgical patients during the SARS-CoV-2 pandemic: A retrospective study

Keywords: Outpatient surgical procedures, Risk behavior, SARS-COV-2 infection, Risk scales, Anesthesiology

Abstract

Introduction: The SARS-CoV-2 pandemic has led to the cancellation of non-emergent surgeries in order to optimize the use of resources. Once the elective medical services are restored, a technical and ethical strategy becomes critical to select candidate patients for elective surgery.

Objective: To describe the results from the implementation of MeNTS (Medically Necessary Time-sensitive Procedures), FI-CGA, and survey on COVID-19 symptoms Scales, as methods for the selection of patients who were candidates for elective surgery during the SARS-CoV-2 pandemic, in a third level institution in Cali, Colombia.

Methodology: The databases of the results on the administration of MeNTS, frailty index (FI-CGA) and COVID 19 symptoms scales in patients who were candidates for elective surgery in a third level clinic in Cali city, between March 1st and August 31st, 2020 were reviewed.

Results: A total of 1,044 patients were included, of which 647 (62.0 %) were females, with a mean age of 52 years (interquartile range [IQR] 38-62). 98 % of the patients were asymptomatic, the overall median score for MeNTS was 48 (IQR 44-52) and the average for FI-CGA was 0.0 (standard deviation 0.1).

Conclusions: MeNTS, FI-CGA and the Symptoms Survey are easily accessible scales amidst the pandemic and are helpful to select patients with intermediate and low risk of perioperative morbidity in elective surgery during the SARS-CoV-2 pandemic. Further studies are required to confirm these findings and to clarify the potential of these tools in the selection of patients that meet the criteria to be identified as high risk.

References

Zhu N, Zhang D, Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-33. doi: https://doi.org/10.1056/NEJMoa2001017

García-Perdomo HA, Beas-Sandoval LR. Teaching in academic and surgical programs in times of COVID-19 [La enseñanza en los programas académicos y quirúrgicos en tiempos de COVID-19]. Revista Mexicana de Urología. 2020;80(2):1-3. doi: https://doi.org/10.48193/rmu.v80i2.622

Barrios A, Prieto R, Torregrosa L, Álvarez C, Hernández JD, González LG, et al. Volver a empezar: cirugía electiva durante la pandemia del SARS-CoV2. Recomendaciones desde la Asociación Colombiana de Cirugía. Rev Colomb Cir. 2020;25(2):302-21. doi: https://doi.org/10.30944/20117582.656

Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg. 2020;155(8):1-14. doi: http://www.doi.org/10.1001/jamasurg.2020.2713.

Rosenbaum L. Facing Covid-19 in Italy. Ethics, logistics, and therapeutics on the epidemic's front line. N Engl J Med. 2020;382(20):1873-5. doi: http://www.doi.org/10.1056/NEJMp2005492.

Prachand VN, Milner R, Angelos P, Posner MC, Fung JJ, Agrawal N, et al. Medically necessary, time-sensitive procedures: Scoring system to ethically and efficiently manage resource scarcity and provider risk during the COVID-19 pandemic. J Am Coll Surg. 2020;231(2):281-8. doi: https://doi.org/10.1016/j.jamcollsurg.2020.04.011

Ministerio de Salud y Protección Social. Envejecimiento demográfico en Colombia 1951-2020. Dinámica demográfica y tendencias poblacionales. Bogotá: Ministerio de Salud y Protección social; 2013.

Hewitt J, Carter B, Vilches-Moraga A, Quinn TJ, Braude P, et al. The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study. Lancet Public Health. 2020;5(8): e444-51. doi: https://doi.org/10.1016/S2468-2667(20)30146-8.

Amblàs-novellas J, Carles J, Molist N, Oller R. Índice frágil-VIG: diseño y evaluación de un índice de fragilidad basado en la valoración integral geriátrica. Rev. Esp. Geriatr Gerontol. 2017;52(3):119-27. doi: https://doi.org/10.1016/j.regg.2016.09.003

Menni C, Valdés AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. 2020;26:1037-40. doi: http://www.doi.org/10.1038/s41591-020-0916-2.

Francis N, Dort J, Cho E, Feldman L, Keller D, Lim R, et al. SAGES and EAES recommendations for minimally invasive surgery during COVID‑19 pandemic. Surg Endosc. 2020;34:2327-31. doi: http://www.doi.org/10.1007/s00464-020-07565-w.

Tafur Betancourt LA, Zorrilla-Vaca A, Vallejos-Medina LP, Chilatra-Fonseca JM, Angarita-Navarro EC, Martínez-Gaviria M et al. Desarrollo del software MyCheckTime® para seguridad perioperatoria con base en la metodología Lean de Toyota. Colombian Journal of Anesthesiology. 2020;48(1):12-9. doi: http://www.doi.org/doi.org/10.1097/cj9.0000000000000148.

Center for Medicare and Medicaid Services. Non-emergent, elective medical services, and treatment recommendations [internet]. 2020 [citado: 2020 nov. 15]. Disponible en: https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf.

Stahel PF. How to risk-stratify elective surgery during the COVID-19 pandemic? Patient Saf Surg. 2020;14:8. doi: http://www.doi.org/10.1186/s13037-020-00235-9.

Royal College of Surgeons of England. Clinical guide to surgical prioritisation during the coronavirus pandemic [internet]. 2020 [citado 2020 nov. 15]. Disponible en: https://www.rcseng.ac.uk/coronavirus/surgical-prioritisation-guidance/

Mayol J, Fernández Pérez C. Elective surgery after the pandemic: waves beyond the horizon. Br J Surg. 2020;107(9):1091-3. doi: http://www.doi.org/10.1002/bjs.11688.

Biase G De, Freeman W, Elder B, Nottmeier E, Smith N, Jerreld D, et al. Path to reopening surgery in the COVID-19 pandemic: Neurosurgery experience. Mayo Clin Proc Innov Qual Outcomes. 2020;4(5):557-64. doi: http://www.doi.org/10.1016/j.mayocpiqo.2020.06.003.

Informe de gestión Nueva EPS. Colombia 2019 [internet]. [citado 2020 nov. 5]. Disponible en: https://nuevaeps.com.co/sites/default/files/inline-files/INFORME%20RENDICION%20DE%20CUENTAS%202019.pdf

COVID-19 en Colombia: Reporte diario de casos [internet]. 2020 [citado 2020 oct 28]. Disponible en: https://www.ins.gov.co/Noticias/Paginas/Coronavirus.aspx

Aggarwal R, Mytton OT, Greaves F, Vincent C. Technology as applied to patient safety: an overview. Qual Saf Health Care. 2010;19(Suppl 2). doi: http://www.doi.org/10.1136/qshc.2010.040501.

COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) [internet] [citado: 2020 oct. 27]. Disponible en: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348(25):2526-34. doi: http://www.doi.org/10.1056/NEJMsa020847.

How to Cite
1.
Tafur Betancourt LA, Rosero Cundar AS, Remolina Granados SA, Arévalo M, Millán G. M del M, Lema Flórez E, Zorrilla Vacca A, Ruiz Holguín VH, Ceballos C, Quintero Soto J. Use of MeNTS, Frailty and Symptom Scales for selecting surgical patients during the SARS-CoV-2 pandemic: A retrospective study . Colomb. J. Anesthesiol. [Internet]. 2021Sep.2 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/999

Downloads

Download data is not yet available.
Published
2021-09-02
How to Cite
1.
Tafur Betancourt LA, Rosero Cundar AS, Remolina Granados SA, Arévalo M, Millán G. M del M, Lema Flórez E, Zorrilla Vacca A, Ruiz Holguín VH, Ceballos C, Quintero Soto J. Use of MeNTS, Frailty and Symptom Scales for selecting surgical patients during the SARS-CoV-2 pandemic: A retrospective study . Colomb. J. Anesthesiol. [Internet]. 2021Sep.2 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/999
Section
Original

More on this topic