The efficacy of recognising high-risk patients by nurses with the use of the Helios Score

Introduction
Optimal risk assessment and medical preparation before surgery is still a problem.

Aim of the research
To compare the adequacy of periprocedural risk assessment performed by an anaesthesiologist during premedication, with the same assessment made by a nurse using the Helios Score in successive patients in the Department of Vascular Surgery.

Material and methods
A total of 185 patients qualified for open vascular surgery in the Vascular Surgery Department of the Pomeranian Medical University in the first quarter of 2018 were studied. The group consisted of patients qualified for surgical treatment with high (n = 65), medium (n = 42), and low (n = 78) operational risk. Retrospective analysis of the prediction accuracy between two methods was performed. There was a comparison between anaesthetist pre-assessment and Helios Score used by the nurse team. The prediction accuracy of death and complication rates were compared between those two methods.

Results
In the analysed period there were seven deaths and 26 cases of general deterioration. In 152 cases, no complications were found. Differences in sensitivity in prediction between anaesthetist and a nurse using the Helios Score were, respectively: death 15% vs. 5.5% (p = 0.283), complications 35% vs. 9.2% (p = 0.036). Simultaneous used of expert assessment and Helios Score could increase the prediction of the death rate to 71%.

Conclusions
The Helios Score helps the nurse team to recognise high-risk patients. Additional use of the Helios Score increases the efficacy of detection of high-risk patients.