The Postoperative Morbidity Survey was validated and used to describe morbidity after major surgery

• Published in: Journal of clinical epidemiology 2007-09, Vol.60 (9), p.919-928
• Main Authors: Grocott, M.P.W, Browne, J.P, Van der Meulen, J, Matejowsky, C, Mutch, M, Hamilton, M.A, Levett, D.Z.H, Emberton, M, Haddad, F.S, Mythen, M.G
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone surgery; Confidence intervals; Elective Surgical Procedures - adverse effects; Elective Surgical Procedures - statistics & numerical data; Epidemiology; Female; General aspects; Health Services Research; Health Surveys; Hospitals, Teaching; Humans; Intensive care; Internal Medicine; Joint surgery; Length of Stay; Male; Medical sciences; Methodology; Middle Aged; Miscellaneous; Morbidity; Mortality; Neurosurgery; Nurses; Operative; Outcome Assessment (Health Care); Pediatrics; Polls & surveys; Postoperative Period; Prevalence; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sensitivity and Specificity; Studies; Surgery; Surgical Procedures; Teaching hospitals; Wound Healing
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2006.12.003

Abstract Objectives To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative morbidity after major elective surgery using the POMS. Study Design and Setting This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative morbidity, was recorded on postoperative days 3, 5, 8, and 15. Results Inter-rater reliability was perfect for 11/18 items (Kappa = 1.0), with Kappa = 0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined morbidity was present in 325 of 433 patients (75.1%) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1%) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of morbidity. Conclusion The POMS is a reliable and valid survey of short-term postoperative morbidity in major elective surgery. Many patients remain in hospital without any morbidity as recorded by the POMS.