Textbook Outcome in Liver Surgery (TOLS) Calculator
Textbook outcome in Liver Surgery (TOLS) is a novel composite measure with an "all or none concept". TOLS combines the most desirable postoperative outcomes after liver surgery into one single measure and embodies the “ideal” postoperative course. It consists of the absence of intraoperative grade ≥ 2 incidents, postoperative bile leak of grade B/C, postoperative liver failure grade B/C, 90-day major postoperative complications, 90-day readmission due to surgery related major complications, 90-day/in-hospital mortality and the presence of R0 resection margin. If a patient meets all 7 desirable postoperative outcomes, TOLS is achieved. The current calculator may aid clinical practie to calculate TOLS for the individual patient following liver surgery.
Research authors: Burak Görgec, Mohammad Abu Hilal
Version: 1.57
  • Public
  • Surgery
  • {{ modelType }}
  • Details
  • Validate model
  • Save input
  • Load input

Calculate the result

Set more parameters to perform the calculation

The patient meets out of 7 surgical variables within the TOLS definition

{{ resultSubheader }}
{{ chart.title }}
Result interval {{ additionalResult.min }} to {{ additionalResult.max }}

Conditional information

- Intraoperative incidents as described in the Oslo classification:

Grade I:

  • Incidents managed without change in operative approach and without further consequences for the patient. This includes minor injury to adherent or adjacent organs and minimal change to intraoperative tactics and procedures with blood loss over the normal range. (e.g. blood loss over 775 ml)
Grade II:
  • Incidents with further consequences for the patient. This includes patients requiring limited resection of organs injured during surgery. For laparoscopic surgery, it includes intraoperative incidents requiring conversion to open operation
Grade III:
  • Incident leading to significant consequences for the patient

 - Grading of severity of bile leakage as described by the International Study group of Liver Surgery:

Grade A:
  • Bile leakage causes no change in patients’ clinical management
Grade B:
  • Bile leakage requires active therapeutic intervention but is manageable without relaparotomy
Grade C:
  • Bile leakage relaparotomy is required

 - Grading of severity of posthepatectomy liver failure as described by the International Study group of Liver Surgery:

Grade A:
  • Posthepatectomy liver failure requires no change of the patient's clinical management.
Grade B:
  • The clinical management of patient deviates from the regular course but does not require invasive therapy.
Grade C:
  • Posthepatectomy liver failure needs invasive treatment.


 

{{ file.classification }}
PRO
Note
Notes are only visible in the result download and will not be saved by Evidencio

This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

Underlying models Part of
Comments
Comment
Please enter a comment
Comments are visible to anyone

Model feedback

No feedback yet 1 Comment {{ model.comments.length }} Comments
On {{ comment.created_at }} {{ comment.user.username }} a no longer registered author wrote:
{{ comment.content }}
logo

Please sign in to enable Evidencio print features

In order to use the Evidencio print features, you need to be logged in.
If you don't have an Evidencio Community Account you can create your free personal account at:

https://www.evidencio.com/registration

Printed results - Examples {{ new Date().toLocaleString() }}

Evidencio Community Account Benefits

With an Evidencio Community account you can:

  • Create and publish your own prediction models.
  • Share your prediction models with your colleagues, research group, organization or the world.
  • Review and provide feedback on models that have been shared with you.
  • Validate your models and validate models from other users.
  • Find models based on Title, Keyword, Author, Institute, or MeSH classification.
  • Use and save prediction models and their data.
  • Use patient specific protocols and guidelines based on sequential models and decision trees.
  • Stay up-to-date with new models in your field as they are published.
  • Create your own lists of favorite models and topics.

A personal Evidencio account is free, with no strings attached!
Join us and help create clarity, transparency, and efficiency in the creation, validation, and use of medical prediction models.

Disclaimer: Calculations alone should never dictate patient care, and are no substitute for professional judgement.
Terms & Conditions | Privacy Policy | Disclaimer | Contact | Refuse cookies |
Evidencio v3.26 © 2015 - 2024 Evidencio. All Rights Reserved