Min et al used the abbreviated VESPA score (Vulnerable Elders Surgical Pathways and Outcomes Assessment) to evaluate an older adult prior to surgery. This can help to identify a patient who may benefit from more aggressive management to avoid complications. The authors are from University of Michigan, University of California San Francisco, and Massachusetts Eye and Ear Infirmary.
Patient selection: surgical patient, age >= 70 years
Parameters:
(1) gender
(2) 5 item functional impairment score (from 0 to 5)
(3) able to manage self alone for a few hours after discharged from the hospital
(4) Charlson Comorbidity Index
(5) surgical complexity
Parameters
Findings
Points
able to transfer
yes
0
no (need help)
1
able to dress
yes
0
no (need help)
1
able to bathe
yes
0
no (need help)
1
able to prepare meals
yes
0
no (need help)
1
able to shop for groceries
yes
0
no (need help)
2
functional impairment score =
= SUM(points for all 5 parameters)
Parameters
Findings
Points
gender
female
0
male
2
functional status
0
0
>= 1
1
able to manage self alone
no
2
yes
0
Charlson comorbidity
0 to 2
0
3 or more
2
surgical complexity
low
0
moderate
2
high
9
VESPA score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• A score >= 9 is associated with postoperative complications.
Performance:
• The sensitivity is 68% and specificity 76%
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