Surgical risk assessment for super‐elderly patients

Aim Super‐elderly patients are often frail and the decision on surgical indications remains a difficult issue. The purpose of this study was to provide a certain preoperative surgical risk assessment tool for super‐elderly people. Methods We selected 112 individuals who were super‐elderly patients a...

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Bibliographic Details
Published in:Geriatrics & gerontology international 2022-04, Vol.22 (4), p.271-277
Main Authors: Miura, Yasuaki, Nishio, Kenji, Kitamura, Yohei, Goto, Tetsuhiro, Yano, Masao, Matsui, So
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Humans
Medical personnel
Musculoskeletal system
over 90 years old
Physiology
Postoperative Complications - epidemiology
Postoperative period
Risk Assessment
Risk Factors
ROC Curve
Sarcopenia
Sarcopenia - diagnosis
skeletal muscle mass index
super‐elderly
surgical risk
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Summary:Aim Super‐elderly patients are often frail and the decision on surgical indications remains a difficult issue. The purpose of this study was to provide a certain preoperative surgical risk assessment tool for super‐elderly people. Methods We selected 112 individuals who were super‐elderly patients aged >90 years who had surgeries under general anesthesia in our department. Based on the quality of the postoperative outcome of each case, we categorized these patients into two groups: good and poor groups. We evaluated the fundamental examination items, such as American Society of Anesthesiologists physical status, skeletal muscle mass index and so on, and a couple of the well‐known risk score systems represented by Estimation of Physiology Ability and Surgical Stress. Results A total of 85 of the 112 patients belonged to the good group and the rest belonged to the poor group. The quality of postoperative outcome is well characterized by Estimation of Physiology Ability and Surgical Stress (P = 0.001). Receiver operating characteristic analysis of Estimation of Physiology Ability and Surgical Stress for the quality of postoperative outcome shows sensitivity of 0.83 and specificity of 0.61. Multivariate logistic regression analysis showed that skeletal muscle mass index and American Society of Anesthesiologists physical status are prominent as the risk determinants affecting the quality of postoperative outcome. A scoring system based on the skeletal muscle mass index, which is a good index of sarcopenia, and American Society of Anesthesiologists physical status, named the “SAP score” has the following characteristics. P‐value
ISSN:1444-1586
1447-0594
DOI:10.1111/ggi.14340