Dr Jawad Saleh: There Are Many Risk Factors for PONV

There are many risk factors for developing postoperative nausea and vomiting (PONV), but a simplified risk score can help with assessing those risk factors, said Jawad N. Saleh, PharmD, BSPharm, BCCCP, BCPS, clinical manager of pharmacy services, Hospital for Special Surgery.

Transcript

What are some of the most common risk factors for postoperative nausea and vomiting? How should these risks be assessed to understand treatment?

The risk factors are vast. If you look into it, there's so many risk factors. But based on the Apfel study, if you look at the Apfel simplified risk score—which I actually encourage and it's also encouraged in the consensus guidelines that were recently published—if you're female, that's a risk factor. If you are a nonsmoker, that's a risk factor. If you have a history of PONV or motion sickness, that's a risk factor. And if you're getting opioids, that's a risk factor.

So those are the 4 Apfel simplified risk factors and, honestly, it puts a large number of people in more of a moderate- or high-risk state of PONV. Keeping that in mind, the average PONV rate is 30%; it’s 80% for high-risk patients. At Hospital for Special Surgery, we've been doing an amazing job—we're well below that number. And hopefully, we continue to reduce that number.