Karabacak Pınar, Bindal Ahmet, Turan İlyas, Erdemoglu Evrim, Ceylan Berit Gökçe
Süleyman Demirel University Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Critical Care Medicine, Isparta, Turkey.
Süleyman Demirel University Faculty of Medicine, Department of Gyneacologic Oncology, Isparta, Turkey.
Turk J Obstet Gynecol. 2023 Sep 4;20(3):179-183. doi: 10.4274/tjod.galenos.2023.04987.
Gynecological malignancies are significant causes of mortality and morbidity in women worldwide. Although surgery is an important treatment method, both the extent of the surgery and the factors related to the patient affect postoperative processes. The National Early Warning Score 2 (NEWS2) is a simple, inexpensive, and safe early warning score developed in 2012 and updated in 2017. Although it is not commonly used in surgical patients, its use in patients who will undergo major surgery may provide insights about the postoperative process. This study investigates the importance of NEWS2 and its relationship in patients with for major gynecologic oncology surgery.
Forty-four patients with gynecologic malignancies scheduled for major abdominal surgery were included in this study. Patients with a NEWS-2 score of <3 were included in group 1, and patients with a NEWS-2 score of more than 3 were included in groups 2. NEWS2 Score, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation 2 scores (APACHE 2) were calculated. In addition, postoperative routine clinical and laboratory parameters were evaluated. Operation time, duration of intubation in the intensive care unit (ICU), the length of the intensive care stay, and length of hospitalization were recorded.
Duration of intubation in the ICU in group 1 with a NEWS2 <3 [8.2 (0-18) vs 16.2 (3-39), respectively; p<0.01], ICU length of stay [21.6 (4-27) vs 47.3 (4-113), respectively; p<0.01], length of hospitalization [11.6 (5-56) vs 18.6 (8-67), respectively; p<0.01]. NEWS2 >3 was significantly higher compared to group 2. The SOFA score was significantly higher in group 2 compared with group 1 [1.2±0.5 vs 4.1±1.9; respectively; p<0.01]. In the correlation analysis, the NEWS2 score level was positively correlated with the SOFA score (p<0.001, r=0.81) and hospitalization time (p<0.001, r=0.60) and neutrophil lymphocyte ratio (NLR) (p<0.001, r=0.47).
These findings suggest that the NEWS2 score may be correlated with the length of intensive care intubation, length of intensive care stay, and length of hospitalization. NEWS2 is an effective and simple scoring system that provides information about postoperative outcomes in gynecologic oncology patients scheduled for major surgery.
妇科恶性肿瘤是全球女性死亡和发病的重要原因。尽管手术是一种重要的治疗方法，但手术范围和与患者相关的因素都会影响术后恢复过程。国家早期预警评分2（NEWS2）是2012年制定并于2017年更新的一种简单、廉价且安全的早期预警评分。虽然它在外科手术患者中并不常用，但在将接受大手术的患者中使用可能会为术后恢复过程提供见解。本研究调查了NEWS2在妇科肿瘤大手术患者中的重要性及其关系。
本研究纳入了44例计划进行腹部大手术的妇科恶性肿瘤患者。NEWS - 2评分<3的患者纳入第1组，NEWS - 2评分大于3的患者纳入第2组。计算NEWS2评分、序贯器官衰竭评估（SOFA）和急性生理与慢性健康状况评估2评分（APACHE 2）。此外，还评估了术后常规临床和实验室参数。记录手术时间、重症监护病房（ICU）插管时间、重症监护停留时间和住院时间。
第1组（NEWS2<3）的ICU插管时间[分别为8.2（0 - 18）与16.2（3 - 39）；p<0.01]、ICU停留时间[分别为21.6（4 - 27）与47.3（4 - 113）；p<0.01]、住院时间[分别为11.6（5 - 56）与18.6（8 - 67）；p<0.01]。与第2组相比，第1组的NEWS2>3显著更低。第2组的SOFA评分显著高于第1组[分别为1.2±0.5与4.1±1.9；p<0.01]。在相关性分析中，NEWS2评分水平与SOFA评分（p<0.001，r = 0.81）、住院时间（p<0.001，r = 0.60）和中性粒细胞淋巴细胞比率（NLR）（p<0.001，r = 0.47）呈正相关。
这些发现表明，NEWS2评分可能与重症监护插管时间、重症监护停留时间和住院时间相关。NEWS2是一种有效且简单的评分系统，可为计划进行大手术的妇科肿瘤患者的术后结果提供信息。
