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Table 3 Effects of preoperative composite risk index in predicting 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

–

–

Composite risk index b

 0

Reference

 

Reference

 

 1

2.604 (1.878–3.612)

< 0.001

2.408 (1.714–3.383)

< 0.001

 2

3.898 (2.437–6.236)

< 0.001

3.235 (1.985–5.272)

< 0.001

  ≥ 3

10.61 (4.239–26.54)

< 0.001

9.227 (3.568–23.86)

< 0.001

Severe arrhythmia c

1.638 (1.008–2.661)

0.046

–

–

Obstructive sleep apnea d

3.347 (1.790–6.258)

< 0.001

2.817 (1.400–5.670)

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

–

–

Surgery by Operative Stress Score h

 Low stress

Reference

 

Reference

 

 Moderate stress

13.05 (1.764–96.51)

0.012

10.23 (1.347–77.71)

0.025

 High stress

26.04 (3.573–189.7)

0.001

15.55 (2.052–117.9)

0.008

 Very high stress

50.77 (6.675–386.1)

< 0.001

22.82 (2.791–186.7)

0.004

Duration of surgery, hour

1.312 (1.200–1.434)

< 0.001

–

–

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 = 5.634, df = 8, P = 0.688
  2. b 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
  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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