Skip to main content

Table 1 Baseline and perioperative data

From: The composite risk index based on frailty predicts postoperative complications in older patients recovering from elective digestive tract surgery: a retrospective cohort study

 

All patients

Without postoperative complications

With postoperative complications

P value

(n = 923)

(n = 666)

(n = 257)

Demographic data

 Age, year

73.5 ± 6.2

73.3 ± 6.1

74.1 ± 6.3

0.092

 Female gender

347 (37.6%)

243 (36.5%)

104 (40.5%)

0.263

 Body mass index

   

0.049

   < 18.5 kg/m2

58 (6.3%)

33 (5.0%)

25 (9.7%)

 

  18.5–23.9 kg/m2

467 (50.6%)

347 (52.1%)

120 (46.7%)

 

  24–27.9 kg/m2

315 (34.1%)

227 (34.1%)

88 (34.2%)

 

   ≥ 28 kg/m2

83 (9.0%)

59 (8.9%)

24 (9.3%)

 

General status

 ASA class

   

< 0.001

  I

7 (0.8%)

5 (0.8%)

2 (0.8%)

 

  II

537 (58.2%)

430 (64.6%)

107 (41.6%)

 

  III

361 (39.1%)

225 (33.8%)

136 (52.9%)

 

  IV

18 (2.0%)

6 (0.9%)

12 (4.7%)

 

 Modified frailty index

   

< 0.001

  0.00

220 (23.8%)

177 (26.6%)

43 (16.7%)

 

  0.09

284 (30.8%)

221 (33.2%)

63 (24.5%)

 

  0.18

194 (21.0%)

139 (20.9%)

55 (21.4%)

 

  0.27

117 (12.7%)

75 (11.3%)

42 (16.3%)

 

  0.36

75 (8.1%)

41 (6.2%)

34 (13.2%)

 

  0.45

23 (2.5%)

9 (1.4%)

14 (5.4%)

 

  0.55

7 (0.8%)

3 (0.5%)

4 (1.6%)

 

  0.64

3 (0.3%)

1 (0.2%)

2 (0.8%)

 

 Malnutritiona

212 (23.0%)

128 (19.2%)

84 (32.7%)

< 0.001

Comorbidities and history b

 Asthma

19 (2.1%)

13 (2.0%)

6 (2.3%)

0.714

 Obstructive sleep apnea c

42 (4.6%)

19 (2.9%)

23 (8.9%)

< 0.001

 Severe arrhythmia d

77 (8.3%)

48 (7.2%)

29 (11.3%)

0.045

 Other cardiac diseases e

24 (2.6%)

15 (2.3%)

9 (3.5%)

0.285

 Mental disorders f

21 (2.3%)

14 (2.1%)

7 (2.7%)

0.570

 Major neurodegenerative diseases g

16 (1.7%)

7 (1.1%)

9 (3.5%)

0.023

 Visual/hearing impairment

31 (3.4%)

18 (2.7%)

13 (5.1%)

0.075

 Chronic renal insufficiency h

31 (3.4%)

17 (2.6%)

14 (5.4%)

0.029

 Chronic hepatic dysfunction i

49 (5.2%)

27 (4.1%)

22 (8.2%)

0.006

 Hyper−/hypothyroidism

19 (2.1%)

14 (2.1%)

5 (1.9%)

0.881

 Chronic corticosteroid therapy j

26 (2.8%)

16 (2.4%)

10 (3.9%)

0.220

 Malignant tumor

741 (80.3%)

514 (77.2%)

227 (88.3%)

< 0.001

 Current smoker/quit ≤4 weeks k

134 (14.5%)

93 (14.0%)

41 (16.0%)

0.442

 Current alcoholism/quit ≤4 weeks l

42 (4.6%)

28 (4.2%)

14 (5.4%)

0.417

Laboratory tests

 Hemoglobin < 90 g/L

82 (8.9%)

41 (6.2%)

41 (16.0%)

< 0.001

 Albumin ≤30 g/L

44 (4.8%)

20 (3.0%)

24 (9.3%)

< 0.001

 Na+ < 135.0 mmol/L

116 (12.6%)

81 (12.2%)

35 (13.6%)

0.550

 Ca++ < 2.1 mmol/L

32 (3.5%)

21 (3.2%)

11 (4.3%)

0.402

 K+ < 3.5 or > 5.5 mmol/L

99 (10.7%)

70 (10.5%)

29 (11.3%)

0.734

Composite risk index m

   

< 0.001

 0

502 (54.4%)

413 (62.0%)

89 (34.6%)

 

 1

306 (33.2%)

196 (29.4%)

110 (42.8%)

 

 2

92 (10.0%)

50 (7.5%)

42 (16.3%)

 

  ≥ 3

23 (2.5%)

7 (1.1%)

16 (6.2%)

 

Intraoperative data

 Type of surgery

   

< 0.001

  Simple general surgeries n

80 (8.7%)

77 (11.6%)

3 (1.2%)

 

  Gastric

154 (16.7%)

100 (15.0%)

54 (21.0%)

 

  Intestinal

556 (60.2%)

414 (62.2%)

142 (55.3%)

 

  Hepatopancreatobiliary

133 (14.4%)

75 (11.3%)

58 (22.6%)

 

 Surgery by Operative Stress Score o

   

< 0.001

  Low stress

56 (6.1%)

55 (8.3%)

1 (0.4%)

 

  Moderate stress

266 (28.8%)

215 (32.3%)

51 (19.8%)

 

  High stress

526 (57.0%)

357 (53.6%)

169 (65.8%)

 

  Very high stress

75 (8.1%)

39 (5.9%)

36 (14.0%)

 

 Duration of surgery, hour

3.2 (2.4, 4.3)

3.0 (2.3, 4.0)

3.6 (2.6, 5.0)

< 0.001

 Type of anesthesia

   

0.346

  General

448 (48.5%)

321 (48.2%)

127 (49.4%)

 

  Combined PNB-general

438 (47.5%)

322 (48.3%)

116 (45.1%)

 

  Combined epidural-general

32 (3.5%)

19 (2.9%)

13 (5.1%)

 

  Neuraxial

5 (0.5%)

4 (0.6%)

1 (0.4%)

 

 Seniority of anesthesiologists

   

0.490

   < 5 years

259 (28.0%)

194 (29.1%)

65 (25.3%)

 

  5 to 10 years

175 (19.0%)

123 (18.5%)

52 (20.2%)

 

   > 10 years

489 (53.0%)

349 (52.4%)

140 (54.5%)

 

 Blood transfusion

64 (6.9%)

33 (5.0%)

31 (12.1%)

< 0.001

 Estimated blood loss, ml

100 (50, 200)

50 (50, 150)

100 (50, 200)

< 0.001

Postoperative data

 Postoperative complications p

257 (27.8%)

–

257 (100.0%)

–

 Clavien-Dindo classification q

   

–

  Grade II

160 (17.3%)

–

160 (62.3%)

 

  Grade III

33 (3.6%)

–

33 (12.8%)

 

  Grade IV

57 (6.2%)

–

57 (22.2%)

 

  Grade V

7 (0.8%)

–

7 (2.7%)

 

 ICU admission

236 (25.6%)

106 (15.9%)

130 (50.6%)

< 0.001

  LOS in ICU, hour

24.0 (18.0, 48.0)

20.0 (16.0, 24.0)

41.0 (20.0, 91.0)

< 0.001

 Unplanned reintubation

12 (1.3%)

0 (0%)

12 (4.7%)

< 0.001

 Unplanned reoperation

28 (3.0%)

0 (0%)

28 (10.9%)

< 0.001

 Hospital LOS, day

16.0 (14.0, 21.0)

15.0 (13.0, 19.0)

21.0 (16.0, 29.0)

< 0.001

  Hospital LOS after surgery, day

10.0 (8.0, 12.0)

9.0 (7.0, 10.0)

13.0 (11.0, 20.0)

< 0.001

 Adverse discharge destination r

15 (1.6%)

0 (0%)

15 (5.8%)

< 0.001

  1. Data are n (%), mean ± SD, or median (interquartile range). P values in bold indicate < 0.05
  2. ASA American Society of Anesthesiologists, PNB peripheral nerve block, ICU intensive care unit, LOS length of stay
  3. a Defined by any of the following: (1) a body mass index of less than 18.5 kg/m2; (2) unintentional weight loss of greater than 10% within the last 3–6 months; or (3) a body mass index of less than 20 kg/m2 and unintentional weight loss of greater than 5% within the last 3–6 months [33]
  4. b Data on 11 items of the modified frailty index are presented in Supplementary Table 1
  5. c Diagnosed by previous polysomnography, or history inquiry and physical examination, and/or STOP-Bang/Berlin questionnaire
  6. d Include atrial fibrillation, frequent (> 6 beats/min) or multifocal ventricular premature beat, paroxysmal supraventricular tachycardia, second/third-degree atrioventricular block, and sick sinus syndrome
  7. e Include congenital heart disease, cardiomyopathy, and valvular heart disease
  8. f Include diagnosed depression, anxiety, schizophrenia, phobia, and hallucination
  9. g Include Alzheimer’s disease, Parkinson’s disease, and dementia
  10. h Refers to estimated glomerular filtration rate < 45 ml/min/1.73 m2 or on dialysis [37]. The CKD-EPI equation was adopted to calculate the estimated glomerular filtration rate [38]
  11. i Defined as Child-Pugh class B and C
  12. j With a duration of > 1 month
  13. k Smoking refers to daily smoking of cigarettes up to half a pack for at least two years
  14. l Alcoholism refers to ethanol consumption ≥40 g/d for men and ≥ 20 g/d for women, lasting for more than 5 years. Ethanol (g) = alcohol consumption (ml) × ethanol content (%) × 0.8 [32]
  15. m A composite of four items, i.e., modified frailty index ≥0.27, malnutrition [33], moderate or severe anemia (hemoglobin < 90 g/L), and severe hypoalbuminemia (albumin ≤30 g/L). Each item was assigned the same weight of 1 point
  16. n Refers to low-risk and 23-h-stay operations including hernia repair, laparoscopic cholecystectomy, appendectomy, and hepatic cyst fenestration
  17. o Stratified into five categories of physiologic stress, i.e., very low stress, low stress, moderate stress, high stress, and very high stress [34]. Also see Supplementary Table 2
  18. p Indicate those of Clavien-Dindo grade II or higher. Also see Supplementary Table 4
  19. q Clavien-Dindo classification of postoperative complications [35]
  20. r Defined as discharge to destinations other than home (e.g., a long- or short-term care facility)
Back to article page

BMC Anesthesiology

ISSN: 1471-2253

Contact us