Prediction of surgical complications in the elderly: Can we improve outcomes?

Mistry, Preeya K.; Gaunay, Geoffrey S.; Hoenig, David M.

doi:10.1016/j.ajur.2016.07.001

Cited by 29 publications

(21 citation statements)

References 46 publications

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“…In order to deliver this aim, it is necessary to include a preoperative risk stratification using a frailty index, for example the ASA score, and cardiopulmonary exercise testing for patients undergoing intra-abdominal surgery, preoperative management of iron deficiency and anemia, and preoperative exercise intervention. Most studies come to the conclusion that further proof is needed of the utility and validity for improving surgical outcomes through advances in preoperative care 8,24 .…”

Section: Assessment and Optimization Of Preoperative Frailty And Predmentioning

confidence: 99%

Frailty assessment and postoperative complications in urologic oncology operations

Κωστακόπουλος¹,

Karakousis²

2020

JFSF

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Major urologic oncology procedures such as radical cystectomy (RC), radical prostatectomy (RP), radical nephroureterectomy (RNU) and radical or partial nephrectomy are the gold standard operations for the treatment of urological malignancies not suitable to be dealt with using minimal invasive procedures such as transurethral resection or other conservative approaches. However, these surgical procedures carry significant risk of complications, especially in elderly and frail patients. The purpose of this review is to highlight the use of a wide variety of preoperative frailty and health status indexes and calculators. Recent data from large population based studies confirm that these calculators can assist physicians and urologists to predict the postoperative morbidity of patients undergoing major operations. Moreover, these frailty calculators can help urologists choose the most suitable and safe treatment for every individual patient. However, the absence of widely accepted specific urologic oncology calculators to predict the association between frailty and postoperative complications emphasizes the necessity for the use of a combination of calculators.

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Section: Assessment and Optimization Of Preoperative Frailty And Predmentioning

confidence: 99%

Frailty assessment and postoperative complications in urologic oncology operations

Κωστακόπουλος¹,

Karakousis²

2020

JFSF

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“…1,8 Bentuk klinis PPC dapat berupa infeksi sistem respirasi/pneumonia, gagal napas (respiratory failure), efusi pleura, atelektasis, pneumotoraks, bronkospasme, sindrom respiratori distres akut (acute respiratory distress syndrome/ARDS), dan pneumonitis aspirasi. 9,10 Berbagai studi menemukan banyak faktor risiko PPC dan mengembangkan model skor prediksi terjadinya PPC, di antaranya skor Arozullah 6,11 dan skor ARISCAT 9 . Studi oleh Widjaya, dkk.…”

Section: Pendahuluanunclassified

Uji Validasi Skor ARISCAT dalam Memprediksi Komplikasi Paru Pascaoperasi di RS Rujukan Tersier di Indonesia

Alkaff¹,

Pitoyo²,

Heriwardito³

et al. 2019

JPDI

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Pendahuluan. Terdapat beberapa instrumen model skor preoperatif yang dapat membantu menilai risiko komplikasi paru pascaoperasi dan diperkirakan ARISCAT merupakan instrumen yang sederhana, memiliki performa yang baik, namun penggunaannya belum luas. Model skor ini belum divalidasi di Indonesia. Penelitian ini dilakukan untuk menilai kemampuan diskriminasi dan kalibrasi skor ARISCAT dalam memprediksi komplikasi paru pascaoperasi pada pasien di RS rujukan tersier di Indonesia. Metode. Penelitian ini adalah kohort retrospektif yang bertujuan untuk menilai kemampuan prediksi skor ARISCAT pada populasi Indonesia. Penelitian ini melibatkan subjek yang menjalani operasi di RSUPN Cipto Mangunkusumo sepanjang tahun 2017. Variabel yang diteliti meliputi usia, saturasi oksigen, riwayat infeksi paru, anemia, jenis pembedahan, durasi operasi, pembedahan darurat, dan kejadian PPC yang terjadi dalam 30 hari pascaoperasi. Validasi eksternal skor ARISCAT dilakukan dengan menilai kemampuan diskriminasi dan kalibrasi. Diskriminasi dinilai dengan area under the curve (AUC) dan kalibrasi dinilai dengan uji Hosmer-Lemeshow dan plot kalibrasi. Hasil. Dari total 428 subjek yang diteliti, kami dapatkan insiden PPC sebesar 32%. Kemampuan diskriminasi menunjukkan nilai AUC sebesar 88,2% (IK 95%; 84,1-92,2%). Kemampuan kalibrasi pada uji Hosmer-Lemeshow menunjukkan nilai p=0,052 dan plot kalibrasi menunjukkan koefisien r=0,968. Simpulan. Skor ARISCAT memiliki kemampuan diskriminasi dan kalibrasi yang baik pada pasien yang menjalani operasi di RSCM.

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“…The elderly patients, especially those with poor functional capacity, are at an increased risk of postoperative pulmonary complications. 5 Previous studies reported preoperative functional capacity to influence postoperative pulmonary complications in patients who underwent lung resection surgery. 6,7 Functional capacity on the 6-minute walking test (6MWT) in patients who underwent lung resection was significantly associated with postoperative pulmonary complications.…”

Section: Introductionmentioning

confidence: 99%

Short-Physical Performance Battery (SPPB) score is associated with postoperative pulmonary complications in elderly patients undergoing lung resection surgery: A prospective multicenter cohort study

et al. 2020

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Elderly patients awaiting lung resection surgery often have poor physical function, which puts them at a high risk of postoperative pulmonary complications. The aim of this study was to investigate the impact of preoperative physical performance on postoperative pulmonary complications in patients awaiting lung resection surgery. In this prospective multicenter cohort study, the characteristics of patients and postoperative pulmonary complications were compared between subjects with low (<10) and high (≥10) Short Physical Performance Battery (SPPB) scores. Postoperative pulmonary complications were defined as over grade II in Clavien-Dindo classification system. We estimated the effects of physical performance on postoperative pulmonary complications using multivariable hierarchical logistic regression. The postoperative pulmonary complications were compared between 331 patients in the high and 33 patients in the low SPPB group. Patients in the low SPPB score group had a significantly higher rate of postoperative pulmonary complications (p < 0.001). Low SPPB score was associated with a higher risk of postoperative pulmonary complications (odds ratio, 8.80; p < 0.001). The SPPB is a clinically useful evaluation tool to assess surgical patients’ physical performance. The low physical performance indicated by the SPPB may be predictive of postoperative pulmonary complications after lung resection surgery. Trial registration: Clinical Trials. University hospital Medical Information Network Center (UMIN-CTR) UMIN000021875.

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Prediction of surgical complications in the elderly: Can we improve outcomes?

Cited by 29 publications

References 46 publications

Frailty assessment and postoperative complications in urologic oncology operations

Frailty assessment and postoperative complications in urologic oncology operations

Uji Validasi Skor ARISCAT dalam Memprediksi Komplikasi Paru Pascaoperasi di RS Rujukan Tersier di Indonesia

Short-Physical Performance Battery (SPPB) score is associated with postoperative pulmonary complications in elderly patients undergoing lung resection surgery: A prospective multicenter cohort study

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