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Table 2 Predictors of postoperative complications

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

Variables

Univariable analyses

Multivariable analysis a

Odds ratio (95% CI)

P value

Odds ratio (95% CI)

P value

Age, year

1.020 (0.997–1.044)

0.092

–

–

Modified frailty index

 0.00

Reference

 

Reference

 

 0.09

1.173 (0.759–1.813)

0.471

1.113 (0.703–1.764)

0.648

 0.18

1.629 (1.032–2.571)

0.036

1.519 (0.931–2.476)

0.094

 0.27

2.305 (1.393–3.815)

0.001

2.250 (1.316–3.848)

0.003

 0.36

3.413 (1.943–5.998)

< 0.001

3.663 (1.996–6.721)

< 0.001

  ≥ 0.45

6.333 (2.921–13.73)

< 0.001

5.495 (2.396–12.60)

< 0.001

Malnutrition b

2.041 (1.476–2.822)

< 0.001

1.522 (1.068–2.170)

0.020

Severe arrhythmia c

1.638 (1.008–2.661)

0.046

–

–

Obstructive sleep apnea d

3.347 (1.790–6.258)

< 0.001

2.776 (1.379–5.586)

0.004

Major neurodegenerative diseases e

3.416 (1.259–9.273)

0.016

–

–

Visual/hearing impairment

1.918 (0.926–3.974)

0.080

–

–

Chronic renal insufficiency f

2.199 (1.068–4.530)

0.033

–

–

Chronic hepatic dysfunction g

2.216 (1.237–3.967)

0.007

–

–

Malignant tumor

2.238 (1.468–3.411)

< 0.001

–

–

Hemoglobin < 90 g/L

2.894 (1.827–4.582)

< 0.001

1.794 (1.072–3.001)

0.026

Albumin ≤30 g/L

3.327 (1.804–6.136)

< 0.001

2.051 (1.032–4.078)

0.040

Surgery by Operative Stress Score h

 Low stress

Reference

 

Reference

 

 Moderate stress

13.05 (1.764–96.51)

0.012

10.34 (1.371–78.04)

0.023

 High stress

26.04 (3.573–189.7)

0.001

15.86 (2.106–119.4)

0.007

 Very high stress

50.77 (6.675–386.1)

< 0.001

22.40 (2.755–182.2)

0.004

Duration of surgery, hour

1.312 (1.200–1.434)

< 0.001

1.127 (1.003–1.266)

0.045

Estimated blood loss, 100 ml

1.094 (1.045–1.146)

< 0.001

-

-

  1. a Factors with P values < 0.20 in univariate analyses or considered clinically important were included in the model. Body mass index was excluded because it was covered by malnutrition; ASA classification was not included because of correlation with the modified frailty index; type of surgery was not included because of correlation with the surgery by Operative Stress Score; intraoperative blood transfusion was not included due to correlation with preoperative anemia or estimated blood loss. The multivariable logistic regression analysis was performed with the backward stepwise method. Hosmer-Lemeshow test for goodness of fit of the multivariable model: χ2 = 11.657, df = 8, P = 0.167
  2. b 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; (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]
  3. c Include atrial fibrillation, frequent (> 6 beats/min) or multifocal ventricular premature beat, paroxysmal supraventricular tachycardia, second/third-degree atrioventricular block, and sick sinus syndrome
  4. d Diagnosed by previous polysomnography, or history inquiry and physical examination, and/or STOP-Bang/Berlin questionnaire
  5. e Include Alzheimer’s disease, Parkinson’s disease, and dementia
  6. f 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]
  7. g Defined as Child-Pugh class B and C
  8. h 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
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BMC Anesthesiology

ISSN: 1471-2253

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