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Predictive Model for the Assessment of Preoperative Frailty Risk in the Elderly

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Abstract
Adequate preoperative evaluation of frailty can greatly assist in the efficient allocation
of hospital resources and planning treatments. However, most of the previous frailty evaluation
methods, which are complicated, time-consuming, and can have inter-evaluator error, are difficult
to apply in urgent situations. Thus, the authors aimed to develop and validate a predictive model
for pre-operative frailty risk of elderly patients by using diagnostic and operation codes, which
can be obtained easily and quickly from electronic records. We extracted the development cohort
of 1762 people who were hospitalized for emergency operations at a single institution between
1 January 2012 and 31 December 2016. The temporal validation cohort from 1 January 2017 to
31 December 2018 in the same center was set. External validation was conducted on 6432 patients
aged 75 years or older from 2012 to 2015 who had emergency surgery in the Korean national
health insurance database. We developed the Operation Frailty Risk Score (OFRS) by assessing the
association of Operation Group and Hospital Frailty Risk Score with the 90-day mortality through
logistic regression analysis. We validated the OFRS in both the temporal validation cohort and two
external validation cohorts. In the temporal validation cohort and the external validation cohort I
and II, the c-statistics for OFRS to predict 90-day mortality were 0.728, 0.626, and 0.619, respectively.
OFRS from these diagnostic codes and operation codes may help evaluate the peri-operative frailty
risk before emergency surgery for elderly patients where history-taking and pre-operative testing
cannot be performed.
Author(s)
김민주김예지남재식이상욱이은호정경운최인철최정현
Issued Date
2021
Type
Article
Keyword
AgeClassificationCodesDatasetselderlyElectronic health recordsemergency operationFrailtyGeriatricsHealth insuranceHospital costshospital frailty risk scoreMedical recordsMortalitySurgeryVariables
DOI
10.3390/jcm10194612
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8505
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_627d45a974904904b524b6b34586ac7d&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Predictive%20Model%20for%20the%20Assessment%20of%20Preoperative%20Frailty%20Risk%20in%20the%20Elderly&offset=0&pcAvailability=true
Publisher
Journal of clinical medicine
Location
스위스
Language
영어
ISSN
2077-0383
Citation Volume
10
Citation Number
19
Citation Start Page
4612
Citation End Page
4612
Appears in Collections:
Medicine > Medicine
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