Association of MeNTS scores with surgical outcomes during COVID-19 pandemic

Editor's Note

In this study from Istanbul University Faculty of Medicine, researchers find that Medically Necessary, Time-Sensitive (MeNTS) scores used for elective surgical prioritization during the COVID-19 pandemic have low discriminating power in distinguishing patients with moderate or severe postoperative complications.

In this analysis, 223 patients were classified according to: postoperative complication severity, Clavien-Dindo <II Group (no/mild complications) or the Clavien-Dindo ≥ II Group (moderate/severe complications); Duke Activity Status Index (DASI); American Society of Anesthesiologists (ASA) physical status class, and other pre-existing conditions and outcomes.

• Mean MeNTS scores were higher in the moderate/severe complication group (50.98) versus the no/mild complication group (44.27), however, disease-related factors were similar.
• DASI scores were lower and ASA class, presence of smoking, leukocytosis, lymphopenia, elevated C-reactive protein (CRP), and ICU requirements were higher in the moderate/severe group.
• MeNTS scores in patients with leukocytosis and elevated CRP were similar to those without elevation and scores were similar in patients with and without lymphopenia.
• There were 8 deaths. MeNtS scores were similar in deceased and living patients.

MeNTS has been endorsed by the American College of Surgeons to triage and make decisions about elective surgery during the COVID-19 pandemic. Higher MeNTS scores were assumed to be related to worse outcomes or increased risk of transmission. This prospective study shows that, although significant, MeNTS scores have low discriminating power in distinguishing patients with moderate or severe complications, the researchers say.