The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

A consultant advisory system for decision support systems

SIGLEAvailable from British Library Document Supply Centre-DSC:6386.750(no 1995: 19) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

IT sourcing A research framework

SIGLEAvailable from British Library Document Supply Centre-DSC:6386.750(1996:16) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The organisation of corporate research centres in advanced engineering technology companies

SIGLEGBUnited Kingdo

Low jitter, long distance pulse transmission near net fibre dispersion zero wavelength

The authors study experimentally ~10 ps return-to-zero pulse propagation near the net dispersion zero of an optical fibre transmission line. Stable near-jitter-free propagation was observed over 70 Mm. Pulse stabilisation and ASE suppression were achieved through the saturable aborber mechanism of nonlinear polarisation rotation

Soliton transmission at 10 Gbit/s over 2022 km of standard fibre with dispersion compensation

We present experimental results of 10 Gbit/s, 20 ps soliton data transmission over standard fibre, dispersion compensated to 0.5 ps/nm/km. Acceptable Q values were measured to a distance of 2022 km

IT for competitive advantage The place of expert systems

SIGLEGBUnited Kingdo

Property performance measurement

SIGLEAvailable from British Library Document Supply Centre- DSC:5294.928(16) / BLDSC - British Library Document Supply CentreGBUnited Kingdo