AI Article Synopsis
- The study aimed to evaluate the effectiveness of various frailty indices in predicting 30-day morbidity and mortality for patients undergoing high-risk surgeries.
- The research utilized a large database of over 283,000 patients who had specific surgical procedures from 2006 to 2017, calculating predictive scores for each frailty index.
- Results showed that while some indices like RAI-rev and RAI-A had fair predictive value for mortality in certain surgery types, all indices performed poorly in predicting morbidity.
Article Abstract
Objective: To determine the effectiveness of the revised Risk Analysis Index (RAI-rev), administrative Risk Analysis Index (RAI-A), cancer-corrected Risk Analysis Index [RAI-rev (cancer-corrected)], and 5-variable modified Frailty Index for predicting 30-day morbidity and mortality in patients undergoing high-risk surgery.
Background: There are several frailty composite measures, but none have been evaluated for predicting morbidity and mortality in patients undergoing high-risk surgery.
Methods: Using the National Surgical Quality Improvement Program database, we performed a retrospective study of patients who underwentcolectomy/proctectomy, coronary artery bypass graft (CABG), pancreaticoduodenectomy, lung resection, or esophagectomy from 2006 to 2017. RAI-rev, RAI-A, RAI-rev (cancer corrected), and 5-variable modified Frailty Index scores were calculated. Pearson's chi-square tests and C-statistics were used to assess the predictive accuracy of each score's logistic regression model.
Results: In the cohort of 283,545 patients, there were 178,311 (63%) colectomy/proctectomy, 38,167 (14%) pancreaticoduodenectomy, 40,328 (14%) lung resection, 16,127 (6%) CABG, and 10,602 (3%) esophagectomy cases. The RAI-rev was a fair predictor of mortality in the total cohort (C-statistic, 0.71, 95% CI 0.70-0.71, P < 0.001) and for patients who underwent colectomy/proctectomy (C-statistic 0.73, 95% CI 0.72-0.74, P < 0.001) and CABG (C-statistic 0.70, 95% CI 0.68-0.73, P < 0.001), but a poor predictor of mortality in all other operation cohorts. The RAI-A was a fair predictor of mortality for colectomy/proctectomy patients (C-statistic 0.74, 95% CI 0.73- 0.74, P < 0.001). All indices were poor predictors of morbidity. The RAI-rev (cancer corrected) did not improve the accuracy of morbidity and mortality prediction.
Conclusion: The presently studied frailty indices are ineffective predictors of 30-day morbidity and mortality for patients undergoing high-risk operations.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292114 | PMC |
| http://dx.doi.org/10.1097/SLA.0000000000004626 | DOI Listing |
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