GERIATRIC Risk Stratification Tool for Older Surgical Patients
Author Information
Author(s): Weinberg Laurence PhD, Lee Dong Kyu PhD, Fletcher Luke MD, Ou Yang Bobby MD, Karp Jadon MD, Koshy Anoop N PhD, Guha Ranjan FANZCA, Slifirski Hugh MD, D’Silva Michael R MD, Bellomo Rinaldo PhD, Churilov Leonid PhD
Primary Institution: Austin Health, Heidelberg, Australia
Hypothesis
The GERIATRIC risk stratification tool would be more accurate than the ACCI in appropriately classifying patients who may or may not develop a postoperative complication or die within their index hospital admission.
Conclusion
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.
Supporting Evidence
- The GERIATRIC risk tool had good discriminative accuracy for any postoperative complication (AUROC, 0.857).
- It outperformed the age-adjusted Charlson Comorbidity Index in classifying patients at risk.
- Patients with congestive heart failure were at the highest risk of developing complications.
- The tool integrates additional factors critical for classifying surgical risk in elderly patients.
Takeaway
This study created a tool to help doctors understand the risks of surgery for very old patients, making it easier to decide if surgery is safe for them.
Methodology
This was a single-center cohort study with retrospective data collection of nonagenarians and centenarians who underwent any surgical or interventional procedures.
Potential Biases
The study may have inherent bias in subjective assessments of patients due to age and perceived frailty.
Limitations
The retrospective study design limited the quality of data collected, and the GERIATRIC risk tool was not able to predict individual patient probabilities of experiencing complications.
Participant Demographics
The mean age was 92.3 years, with 49.7% females and 96.5% classified as ASA class 3.
Statistical Information
P-Value
0.05
Confidence Interval
95% CI = 0.824–0.890
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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