J Korean Med Sci.  2005 Oct;20(5):811-815. 10.3346/jkms.2005.20.5.811.

A Korean Predictive Model for Postoperative Nausea and Vomiting

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hjahn@smc.samsung.co.kr

Abstract

Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after surgery. An identification of risk factors associated with PONV would make it easier to select specific patients for effective antiemetic therapy. We designed a case-controlled study to identify the risk factors for PONV in 5,272 surgical patients. At postoperative 2 and 24 hr, patients were visited and interviewed on the presence and severity of PONV. Thirty nine percent of patients experienced one or more episodes of nausea or vomiting. Five risk factors were highly predictive of PONV: 1) female, 2) history of previous PONV or motion sickness, 3) duration of anesthesia more than 1 hour, 4) non-smoking status, and 5) use of opioid in the form of patient controlled analgesia (PCA), in the order of relevance. The formula to calculate the probability of PONV using the multiple regression analysis was as follows: P (probability of PONV)=1/1+e(-Z), Z=-1.885+0.894 (gender)+0.661 (history)+0.584 (duration of anesthesia)+0.196 (smoking status) +0.186 (use of PCA-based opioid) where gender: female=1, male=0; history of previous PONV or motion sickness: yes=1, no=0; duration of anesthesia: more than 1 hr=1, less than or 1 hr=0; smoking status: no=1, yes=0; use of PCA-based opioid: yes=1, no=0.

Keyword

Models, Statistical; Postoperative Nausea and Vomiting; Risk Factors

MeSH Terms

Anesthesia/*statistics and numerical data
Case-Control Studies
Female
Humans
Korea/epidemiology
Male
Outcome Assessment (Health Care)/*methods
Postoperative Nausea and Vomiting/*epidemiology
Prevalence
Prognosis
*Proportional Hazards Models
Reproducibility of Results
Research Support, Non-U.S. Gov't
Risk Assessment/*methods
Risk Factors
Sensitivity and Specificity

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Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy
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