The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool
Objective:. To develop age-appropriate nonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) risk tool for classifying patients who may or may not develop postoperative complications or die within their index hospital admission. Background:. There are no validated perioperative risk stratification tools...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000524 |
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| author | Laurence Weinberg, PhD Dong Kyu Lee, PhD Luke Fletcher, MD Bobby Ou Yang, MD Jadon Karp, MD Anoop N Koshy, PhD Ranjan Guha, FANZCA Hugh Slifirski, MD Michael R D’Silva, MD Rinaldo Bellomo, PhD Leonid Churilov, PhD |
| author_facet | Laurence Weinberg, PhD Dong Kyu Lee, PhD Luke Fletcher, MD Bobby Ou Yang, MD Jadon Karp, MD Anoop N Koshy, PhD Ranjan Guha, FANZCA Hugh Slifirski, MD Michael R D’Silva, MD Rinaldo Bellomo, PhD Leonid Churilov, PhD |
| author_sort | Laurence Weinberg, PhD |
| collection | DOAJ |
| description | Objective:. To develop age-appropriate nonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) risk tool for classifying patients who may or may not develop postoperative complications or die within their index hospital admission.
Background:. There are no validated perioperative risk stratification tools for use in nonagenarian and centenarian patients—people aged 90 to 99 years and >100 years.
Methods:. In this retrospective observational study, nonagenarians and centenarians undergoing any surgical procedure were profiled. Surgery severity was stratified, and the incidence and grade of postoperative complications were recorded. Multivariable logistic regression analysis was performed on a training cohort, followed by calibration on a validation cohort, followed by performance evaluation on a testing cohort. The discriminative accuracy was compared to that of the age-adjusted Charlson Comorbidity Index for each outcome. The primary outcome was the ability of the risk stratification tool to effectively classify patients into those who may or may not experience a postoperative complications or mortality within their index hospital stay.
Results:. A total of 3085 patients were enrolled. The GERIATRIC risk tool had good discriminative accuracy for any postoperative complication [area under the receiver operating characteristic curves (AUROC), 0.857; 95% CI = 0.824–0.890] and any severe postoperative complication (AUROC, 0.833; 95% CI = 0.793–0.874), and fair discriminative accuracy for in-hospital mortality (AUROC, 0.780; 95% CI = 0.668–0.893).
Conclusions:. Compared to the age-adjusted Charlson Comorbidity Index, The GERIATRIC risk tool was accurate in classifying patients into those who may or may not experience severe complications or die during their index admission. The tool can be used to assist perioperative clinicians with shared decision-making and short-term prognostication. |
| format | Article |
| id | doaj-art-e4b5ba3d22f248d1a67de59dbde467bc |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-e4b5ba3d22f248d1a67de59dbde467bc2025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e52410.1097/AS9.0000000000000524202412000-00025The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification ToolLaurence Weinberg, PhD0Dong Kyu Lee, PhD1Luke Fletcher, MD2Bobby Ou Yang, MD3Jadon Karp, MD4Anoop N Koshy, PhD5Ranjan Guha, FANZCA6Hugh Slifirski, MD7Michael R D’Silva, MD8Rinaldo Bellomo, PhD9Leonid Churilov, PhD10From the * Department of Anesthesia, Austin Health, Heidelberg, Australia‡ Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of KoreaFrom the * Department of Anesthesia, Austin Health, Heidelberg, AustraliaFrom the * Department of Anesthesia, Austin Health, Heidelberg, AustraliaFrom the * Department of Anesthesia, Austin Health, Heidelberg, Australia‖ Department of Cardiology, Austin Health, Heidelberg, AustraliaFrom the * Department of Anesthesia, Austin Health, Heidelberg, AustraliaFrom the * Department of Anesthesia, Austin Health, Heidelberg, AustraliaFrom the * Department of Anesthesia, Austin Health, Heidelberg, Australia† Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia# Department of Medicine, Royal Melbourne Hospital, Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, Faculty of Medicine, The University of Melbourne; Melbourne, AustraliaObjective:. To develop age-appropriate nonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) risk tool for classifying patients who may or may not develop postoperative complications or die within their index hospital admission. Background:. There are no validated perioperative risk stratification tools for use in nonagenarian and centenarian patients—people aged 90 to 99 years and >100 years. Methods:. In this retrospective observational study, nonagenarians and centenarians undergoing any surgical procedure were profiled. Surgery severity was stratified, and the incidence and grade of postoperative complications were recorded. Multivariable logistic regression analysis was performed on a training cohort, followed by calibration on a validation cohort, followed by performance evaluation on a testing cohort. The discriminative accuracy was compared to that of the age-adjusted Charlson Comorbidity Index for each outcome. The primary outcome was the ability of the risk stratification tool to effectively classify patients into those who may or may not experience a postoperative complications or mortality within their index hospital stay. Results:. A total of 3085 patients were enrolled. The GERIATRIC risk tool had good discriminative accuracy for any postoperative complication [area under the receiver operating characteristic curves (AUROC), 0.857; 95% CI = 0.824–0.890] and any severe postoperative complication (AUROC, 0.833; 95% CI = 0.793–0.874), and fair discriminative accuracy for in-hospital mortality (AUROC, 0.780; 95% CI = 0.668–0.893). Conclusions:. Compared to the age-adjusted Charlson Comorbidity Index, The GERIATRIC risk tool was accurate in classifying patients into those who may or may not experience severe complications or die during their index admission. The tool can be used to assist perioperative clinicians with shared decision-making and short-term prognostication.http://journals.lww.com/10.1097/AS9.0000000000000524 |
| spellingShingle | Laurence Weinberg, PhD Dong Kyu Lee, PhD Luke Fletcher, MD Bobby Ou Yang, MD Jadon Karp, MD Anoop N Koshy, PhD Ranjan Guha, FANZCA Hugh Slifirski, MD Michael R D’Silva, MD Rinaldo Bellomo, PhD Leonid Churilov, PhD The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool Annals of Surgery Open |
| title | The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool |
| title_full | The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool |
| title_fullStr | The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool |
| title_full_unstemmed | The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool |
| title_short | The Perioperative NonaGEnaRIan And cenTenarian suRgICal (GERIATRIC) Risk Stratification Tool |
| title_sort | perioperative nonagenarian and centenarian surgical geriatric risk stratification tool |
| url | http://journals.lww.com/10.1097/AS9.0000000000000524 |
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