Langenbecks Arch Surg (2006) 391: 418–427 DOI 10.1007/s00423-005-0020-6 ORIGINAL ARTICLE Artur Bauhofer Wilfried Lorenz Michael Koller Henrik Menke Daniel I. Sessler Helmut Sitter Ilhan Celik Christoph Nies Hinnerk Wulf Alexander Torossian Received: 11 March 2005 Accepted: 13 December 2005 Published online: 7 February 2006 # Springer-Verlag 2006 Evaluation of the McPeek postoperative outcome score in three trials Abstract Background: Postopera- tive outcome of patients is determined by recovery characteristics and self- reported quality of life. The first can be assessed with the McPeek score which values three aspects of recov- ery: mortality, postoperative critical care and duration of hospitalization. Materials and methods: We calcu- lated the McPeek score of 669 pa- tients in three trials: (1) colorectal cancer surgery, (2) antihistamine/vol- ume loading in various operations, and (3) cholecystectomy. Beforehand, the average of intensive care unit treatment and duration of hospital- ization were determined for the dif- ferent operations to define McPeek score points. The score was tested on reliability, validity, and sensitivity. In addition, clinical applicability was assessed in a survey. Results: The score was reliable with similarly distributed score points in the three trials at different institutions. Inter- rater reliability was high (97% over- lap). Validity was proven by moderate high correlation to convergent criteria such as complications (trial I to III r=0.43, r=0.38, r=0.60), preoperative American Society of Anesthesiolo- gists class (ASA) (r=0.24, r=0.28, r=0.57), and age (r=0.23, r=0.32, r=0.31). The score was different between patients with and without neoplasms (P<0.001, trial II) and between elective or emergency pa- tients (P<0.001, trial III). In a survey, investigators reported that the score was easy to assess and more com- prehensive than four other scores. Conclusions: The McPeek score va- lues the postoperative outcome on a nonlinear scale. A priori, the average duration of hospitalization and critical care for a specific operation has to be defined. Our validation suggests that it is a reliable, valid, sensitive, and practical instrument for outcome analysis after anesthesia and surgery. Keywords Outcome score . Recovery score . Outcome . Score evaluation . Index Introduction The success of surgical treatment is traditionally judged by a single parameter: 30-day mortality. This is an important endpoint, but it is insensitive, as death in the perioperative period is now often less than 1% [1, 2]. Another common endpoint is duration of hospitalization, but this endpoint does not include adverse events such as mortality and the need of critical care. Duration of hospitalization is more and more determined by clinical policies [3]. However, with A. Bauhofer (*) . W. Lorenz . M. Koller . H. Sitter . I. Celik Institute of Theoretical Surgery, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany e-mail: a-bauhofer@web.de Tel.: +49-6421-681075 Fax: +49-6421-614880 H. Menke Clinic of Plastic, Aesthetic and Hand Surgery Burn Center, Offenbach/Main, Starkenburgring 66, 63069 Offenbach, Germany D. I. Sessler Cleveland Clinic Foundation, Outcomes Research Institute, Cleveland, OH 44195, USA C. Nies Clinic of Visceral, Thorax and Vascular Surgery, Marienhospital Osnabrück, Johannisfreiheit 2-4, 49074 Osnabrück, Germany H. Wulf . A. Torossian Clinic of Anesthesia and Critical Care, Philipps-University Marburg, Baldingerstrasse, 35043 Marburg, Germany