Article Figures & Tables
Tables
Variable 1 2 3 4 5 Procedure factors OR time, min < 30 30–60 60–120 120–180 ≥180 Surgical team size, n 1 2 3 4 > 4 Estimated LOS Outpatient < 23 h 24–48 h ≤ 3 d > 4 d Need for GA No Yes Disease factors Availability & acceptability/ effectiveness of nonsurgical treatment option** None available or high SE Available but < 40% as effective as surgery or moderate SE Available and 40% to 60% as effective as surgery Available and 60% to 95% as effective as surgery, low risk of SE Available and equally effective Vision that falls below functional needs** Monocular patient Difficulty with ADLs or significant impact on development Below driving/ occupational requirements or moderate impact on development Approaching driving/occupational requirements or minimal impact on development No functional limitation or impact on development Disease process causes irreversible vision loss Never reversible Partially reversible, central-involving Partially reversible, non-central-involving Always reversible Risk of significant vision loss or progressive disease with 6-wk delay Extremely high High Moderate Low Extremely low or none Impact of 6-wk delay in increase surgical difficulty, surgical risk, or risk of additional intervention Significantly worse Worse Moderately worse Slightly worse No worse COVID-19 exposure risk of nonoperative treatment compared with surgery** Not applicable/ significantly worse Somewhat worse Equivalent Somewhat better Significantly better Patient factors Age, yr < 20 20–50 51–69 70–79 ≥ 80 Fall risk High risk Moderate risk Minimal risk No fall risk Degree of pain or poor QOL (i.e., diplopia) Extreme distress or discomfort Moderate distress or discomfort Low distress or discomfort No distress or discomfort Social factors complicating care** Significant social factors Few social factors No social factors Lung disease (asthma, COPD, CF) None — — Minimal (rare inhaler) > Minimal Obstructive sleep apnea Not present — — Mild/moderate (no CPAP) On CPAP CV disease (HTN, CHF, CAD) None Minimal (no meds) Mild (≤ 1 med) Moderate (2 meds) Severe (≥ 3 meds) Diabetes None — Mild (no meds) Moderate (PO meds only) > Moderate (insulin) Immunocompromised No Moderate Severe ILI symptoms (fever, cough, sore throat, body aches, diarrhea) None (asymptomatic) — — — Yes Exposure to known COVID-19 positive person in past 14 d No Probably not Possibly Probably Yes ADL = activities of daily living; CAD = coronary artery disease; CF = cystic fibrosis; CHF = congestive heart failure; COPD = chronic obstructive pulmonary disease; CPAP = continuous positive airway pressure; CV = cardiovascular; GA = general anesthesia; HTN = hypertension; ILI = influenza like illness; LOS = length of stay; OR = operating room; PO = per os; QOL = quality of life.
* Shaded rows were unchanged from the original scoring system. (3) Reprinted from Prachand VN, Milner R, Angelos P, et al. Medically Necessary, Time-Sensitive Procedures: scoring system to ethnically and efficiently manage resource scarcity and provider risk during the COVID-19 pandemic. J Am Coll Surg 2020;231:281–288, with permission from Elsevier.
↵** Additional explanation of these variables available in Prachand et al. (3)