Costa et al reported the Emergency Surgery Frailty Index (EmSFI) for an older adult undergoing emergency surgery. This can help to identify a patient who may require more aggressive management. The authors are from "Sapienza" University of Rome, Santo Spirito in Sassia Hospital, Catholic University of the Sacred Heart and Cristo Re Hospital in Rome.
Patient selection: adult >= 65 years of age undergoing emergency surgery
Parameters:
(1) age in years
(2) surgical acuity
(3) SIRS
(4) malignancy
(5) chronic cardiopathy
(6) chronic pneumopathy
(7) other comorbidities
(8) altered autonomy (dependency)
(9) altered mobility
Parameter
Finding
Points
age in years
< 80 years
0
>= 80 years
1
surgical acuity
emergency
1
non-emergency
0
SIRS
no
0
yes
1
malignancy
no
0
yes
1
chronic cardiopathy
no
0
mild
1
severe
2
chronic pneumopathy
no
0
mild
1
severe
2
other comorbidity
no
0
mild
1
severe
2
altered autonomy
no
0
mild
1
severe
2
altered mobility
no
0
mild
1
severe
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 1(for emergency surgery)
• maximum score: 14
• The higher the score the worse the outcomes.
Total Score
Risk Group
Morbidity
Mortality
1 to 3
low
25%
4.1%
4 to 7
moderate
41%
14.4%
8 to 14
high
52%
30.4%
Performance:
• The area under the ROC curve is 0.76.
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