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).
- The GERIATRIC risk tool outperformed the ACCI in classifying patients who may or may not die during their index hospital stay.
- Patients with congestive heart failure were at the highest risk of developing postoperative complications.
- Over 3000 patients were included in the study, providing a robust dataset for analysis.
- The tool integrates additional factors critical for classifying patients into those likely or unlikely to experience complications.
Takeaway
This study created a special tool to help doctors understand the risks for very old patients (90 years and older) who are having surgery, 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
p<0.05
Confidence Interval
95% CI = 0.824–0.890
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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