Geriatric Rescue After Surgery (GRAS) Score of Kahn et al for a Geriatric Patient Undergoing Emergency General Surgery

Description

Kahn et al developed a score for the preoperative evaluation an older adult undergoing emergency general surgery. The score can help to identify a patient for whom there is a high risk for failure-to-rescue (FTR). The authors are from the University of Arizona in Tucson.

Patient selection: emergency general surgery in a patient >= 65 years of age

Outcome: failure to rescue (FTR)

Parameters:

(1) age in years

(2) ASA class

(3) serum albumin in g/dL

(4) congestive heart failure (CHF)

(5) chronic renal failure (CRF)

(6) COPD

Parameter	Finding	Points
age in years	< 80 years	0
	>= 80 years	2
ASA class	1, 2 or 3	0
	4 or 5	2
serum albumin	>= 3.5 g/dL	0
	< 3.5 g/dL	1
CHF	absent	0
	present	1
CRF	absent	0
	present	1
COPD	absent	0
	present	1

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 8

• The higher the score the score the worse the prognosis and the greater the risk of failure to rescue (FTR).

Total Score	Risk Group	Percent FTR
0 to 2	low	< 4%
3 to 5	moderate	7 to 43%
6 to 8	high	55 to 100%

Performance:

• The area under the ROC curve is 0.79.

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Geriatric Rescue After Surgery (GRAS) Score of Kahn et al for a Geriatric Patient Undergoing Emergency General Surgery

Description

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