New scoring system to ethically, efficiently prioritize surgical procedures during COVID-19 pandemic

Editor's Note

Researcher at the University of Chicago have developed a new scoring system that helps surgeons across all specialties decide when to proceed with necessary surgical procedures in the face of resource constraints and increased risks posed by COVID-19.

The process, called Medically Necessary, Time-Sensitive (MeNTS) prioritization, was created by a team of six representatives from general surgery, vascular surgery, surgical oncology, transplantation, cardiac surgery, otolaryngology, and surgical ethics.

The scoring system includes 21 factors that are scored on a scale of 1 to 5, and the total score, which ranges from 21 to 105, is computed for each case. The higher the score, the greater chance of poorer patient outcomes, the higher the use of hospital resources, and the higher the risk of COVID-19 transmission to the healthcare team.

After using MeNTS for about 2 weeks, University of Chicago surgeons increased the number of medically necessary, time-sensitive surgical procedures to about 15 per day.

The system does not apply only to academic centers in big cities, but it can be applied anywhere. The factors are fundamental and straightforward and can help surgeons and hospitals provide care that patients need now and on the other side of the peak, the researchers say.