Shulman et al reported a model for predicting death or disability for an older adult following surgery. The authors are from MOnash University and Alfred Hospital in Melbourne.
Point selection: surgical patient >= 70 years of age
Outcome: death or final WHODAS >= 35%
Parameters:
(1) baseline WHODAS score in percent, from 0 to 100
(2) age in years
(3) dementia
(4) chronic kidney disease
Parameter
Finding
Points
WHODAS
1.5 * (WHODAS) / 10
age in years
2 * (age) /10
dementia
no
0
yes
6
chronic kidney disease
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 14
• maximum score: around 48
• The higher the score the greater the risk of disability or death.
Score
Death or Disability
14 to 16
18%
16.01 to 18
30%
18.01 to 22
45%
> 22
75%
Performance:
• The area under the ROC curve was 0.70 for the derivation and 0.74 for the validation cohorts.
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