Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Dirk J van der WindtAllan Tsung

Abstract

The Risk Analysis Index (RAI) for frailty is a rapid survey for comorbidities and performance status, which predicts mortality after general surgery. We aimed to validate the RAI in predicting outcomes after hepatopancreatobiliary surgery. Associations of RAI, determined in 162 patients prior to undergoing hepatopancreatobiliary surgery, with prospectively collected 30-day post-operative outcomes were analyzed with multivariate logistic and linear regression. Patients (age 62 ± 14, 51% female) had a median RAI of 7, range 0-25. With every unit increase in RAI, length of stay increased by 5% (95% CI: 2-7%), odds of ICU admission increased by 10% (0-20%), ICU length of stay increased by 21% (9-34%), and odds of discharge to a nursing facility increased by 8% (0-17%) (all P < 0.05). Particularly in patients who suffered a first post-operative complication, RAI was associated with additional complications (1.6 unit increase in Comprehensive Complication Index per unit increase in RAI, P = 0.002). In a direct comparison in a subset of 74 patients, RAI and the ACS-NSQIP Risk Calculator performed comparably in predicting outcomes. While RAI and ACS-NSQIP Risk Calculator comparatively predicted short-term outcomes after HPB surgery, RA...Continue Reading

Citations

May 10, 2020·Anesthesia and Analgesia·Lolita S NidadavoluEsther S Oh
Dec 31, 2020·Anesthesiology·Sylvie D AucoinDaniel I McIsaac
Jan 12, 2021·Surgical Oncology·Claudia PaoliniAndrea Coratti
Jan 9, 2021·Gynecologic Oncology·Violante Di DonatoPierluigi Benedetti Panici
Nov 7, 2020·The American Surgeon·Tyler McKechniePablo E Serrano

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