Revenig et al developed a simple model for predicting frailty in an older adult undergoing major intra-abdominal surgery. This can help to predict short-term postoperative morbidity and mortality. The authors are from Emory University, Winship Cancer Institute, Einstein Health Network and the Urologic Institute of Southeastern Pennsylvania.
Patient selection: adult following major intra-abdominal surgery (age >= 19 years)
Parameters:
(1) shrinking and weak grip strength (from frailty phenotype of Fried et al)
(2) hemoglobin in g/dL and gender
(3) ASA classification
Parameter
Finding
Points
shrinking and weak grip strength
neither
0
either
1
both
3
hemoglobin and gender
< 12.9 g/dL and male
1
< 11.4 g/dL and female
1
other
0
ASA class
ASA 1 or 2
0
ASA 3, 4 or 5
1
where:
• A person with ASA class 5 would be at high risk regardless of other findings.
composite risk score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk for frailty.
Score
Risk
Any Major 30-Day Complication
0
low
23%
1 or 2
intermediate
37%
3, 4 or 5
high
59%
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