Sungworawongpana Chutida, Chaichulee Sitthichok, Chaochankit Wongsakorn, Vichitkunakorn Polathep, Gosiyaphant Nachawan, Thongaek Chayaporn Subanphanichkul, Boonchai Ratikorn, Sutthibenjakul Karuna, Tantisarasart Thadakorn
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Department of Biological Sciences and Biological Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
J Clin Med. 2025 Apr 10;14(8):2603. doi: 10.3390/jcm14082603.
This study aimed to develop a scoring system that predicts postoperative oxygen requirements, enhances clinical decision-making, reduces unnecessary oxygen use, and improves the efficiency of postoperative respiratory care. This retrospective study included patients who underwent elective non-cardiac surgery with general anesthesia between 1 January 2018 and 31 December 2022. The outcome of the study was the postoperative oxygen requirement at PACU discharge. Predictors with significance were used to create a scoring system. Among the 42,378 cases, 14.9% required supplemental oxygen at PACU discharge. The WHO2SAFE score, which ranges from 0 to 15, incorporates eight independent risk factors, given in the mnemonic WHOSAFE: intraoperative wheezing, intraoperative hypotension, obesity, operative time ≥ 180 min, sleep apnea, ASA classification ≥ 3, female, and elderly. The WHOSAFE score provides a practical tool for predicting the need for supplemental oxygen at PACU discharge via the web, facilitating early intervention and efficient resource utilization. A cutoff score of 6 facilitates clinicians to identify high-risk patients who benefit from close observation while minimizing unnecessary oxygen use in low-risk individuals.
本研究旨在开发一种评分系统，用于预测术后氧气需求，加强临床决策，减少不必要的氧气使用，并提高术后呼吸护理的效率。这项回顾性研究纳入了2018年1月1日至2022年12月31日期间接受择期非心脏手术全身麻醉的患者。研究的结果是患者在麻醉后护理单元（PACU）出院时的术后氧气需求。具有显著意义的预测因素被用于创建一个评分系统。在42378例病例中，14.9%的患者在PACU出院时需要补充氧气。WHO2SAFE评分范围为0至15分，包含八个独立的风险因素，由助记符WHOSAFE给出：术中哮鸣、术中低血压、肥胖、手术时间≥180分钟、睡眠呼吸暂停、美国麻醉医师协会（ASA）分级≥3级、女性和老年。WHOSAFE评分为通过网络预测PACU出院时补充氧气的需求提供了一个实用工具，有助于早期干预和高效利用资源。临界值为6分有助于临床医生识别从密切观察中获益的高危患者，同时尽量减少低危个体不必要的氧气使用。
