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366569

The implement of Preoperative 11-items modified Frailty Index and the Surgical Apgar Score might predict the Postoperative Complication Rate in Old Patients undergoing Major Abdo

Article

Last updated: 27 Dec 2024

Subjects

-

Tags

Anesthesia.

Abstract

Background: Frailty is associated with significant diminution of physiologic reserve and worse postoperative (PO) outcomes after major abdominal surgeries (MAS). Objectives are evaluation of the applicability of frailty indices (FI) and the Surgery Apgar score (SAS) for intraoperative events as predictors for the frequency and severity of 30-d PO complications as judged by the Clavien-Dindo classification and PO mortality rate (MR). Patients and methods: 125 patients aged ≥60 years were evaluated preoperatively for frailty using the 11-item and 5-item modified FI (11-mFI & 5-mFI) and during surgery for intraoperative events using SAS. Patients were monitored for 30-d PO for development of complications according to the 5-grade Clavien-Dindo classification. Results: The 11-mFI and 5-mFI detected 85 (68%) and 70 (56%) frail patients, respectively. Among non-frail patients 65% had SAS ≥7, while 77.6% of frail patients had SAS ≤4. Seven non-frail and 30 frail patients developed complications and one non-frail and 5 frail patients died. ROC curve analysis defined high frailty scores as the significant early predictors of SAS≤4 and low SAS with high 5-mFI score as significant predictors for frequency and severity of PO complications. Multivariate Regression analysis defined low SAS and high 5-mFI score as the significant predictors for PO complications and MR, respectively.  Conclusion: Low SAS is common among frail patients and both low SAS and high score on FIs might be used as early predictors for PO severe complications and mortality of patients undergoing major abdominal surgeries.

DOI

10.21608/svuijm.2024.298695.1900

Keywords

Old patients, Major abdominal surgeries, Frailty indices, Surgical Apgar Score, Complication rate, mortality rate

Authors

First Name

Tamer M.

Last Name

Allam

MiddleName

-

Affiliation

Department of Anesthesia & ICU, Faculty of Medicine, Benha University, Benha, Egypt.

Email

tamerallam@fmed.bu.edu.eg

City

Benha

Orcid

-

First Name

Yehya Shahin

Last Name

Dabour

MiddleName

-

Affiliation

Department of Anesthesia & ICU, Faculty of Medicine, Benha University, Benha, Egypt.

Email

yehyadabour@gmail.com

City

Benha

Orcid

0000-0002-2559-7232

First Name

Hany A.

Last Name

Shehab

MiddleName

-

Affiliation

Department of Anesthesia, Pain & ICU, Faculty of Medicine, Cairo University, Cairo, Egypt.

Email

hanyshehab603@yahoo.com

City

Cairo

Orcid

-

Volume

7

Article Issue

2

Related Issue

47977

Issue Date

2024-07-01

Receive Date

2024-06-23

Publish Date

2024-07-01

Page Start

299

Page End

312

Print ISSN

2735-427X

Online ISSN

2636-3402

Link

https://svuijm.journals.ekb.eg/article_366569.html

Detail API

https://svuijm.journals.ekb.eg/service?article_code=366569

Order

366,569

Type

Original research articles

Type Code

1,520

Publication Type

Journal

Publication Title

SVU-International Journal of Medical Sciences

Publication Link

https://svuijm.journals.ekb.eg/

MainTitle

The implement of Preoperative 11-items modified Frailty Index and the Surgical Apgar Score might predict the Postoperative Complication Rate in Old Patients undergoing Major Abdominal Surgeries: Observational Prospective Study

Details

Type

Article

Created At

27 Dec 2024