Gani et al reported a revised frailty index for evaluating a patient undergoing liver surgery. This can help to identify a patient who may require more aggressive management. The authors are from the Johns Hopkins University and the Ohio State University.
Patient selection: liver resection
Parameters:
(1) type of operation
(2) type of liver disease
(3) body mass index (BMI) in kg per square meter
(4) preoperative serum albumin in g/dL
(5) preoperative hematocrit in percent
(6) ASA status
Parameter
Finding
Points
type of operation
lobectomy
0
total left lobectomy
2.8
total right lobectomy
7.5
trisegmentectomy
10
liver disease
benign disease
0
metastatic liver tumors
1.3
primary liver cancer
6.4
biliary tract cancer
6.4
BMI
overweight
0
obese
0
normal (18.5 to 24.9)
2.6
underweight
7.6
preoperative albumin
>= 3.5 g/dL
0
< 3.5 g/dL
4.6
preoperative hematocrit
normal
0
low (anemia)
4.8
ASA status
ASA 1 or 2
0
ASA 3 or 4
4.5
total score =
= SUM (points for all of the parameters)
value of X =
= (0.1056 * (score)) - 1.96
probability of complication or death =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.68.
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