Hall et al reported the Risk Analysis Index (RAI) for evaluation of surgical patients. The authors are from multiple Veterans Affairs hospitals and affiliated universities in the United States.
Patient selection: adult surgical patient (mean age 60.7 years)
Outcomes: 30, 180 and 365 mortality; any complication except SSI or UTI; any Clavien Dindo IV complications
Parameters:
(1) sex
(2) age in years
(3) presence of cancer (excluding minor skin cancers)
(4) unintended weight loss in the past 3 months > 10 pounds
(5) renal failure
(6) chronic or congestive heart failure
(7) poor appetite
(8) shortness of breath at rest
(9) living (independent vs other facility)
(10) mobility and locomotion
(11) eating
(12) toilet use
(13) personal hygiene
(14) cognitive decline over the past 3 months
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
5 |
|
age |
< 70 without cancer |
2 |
|
|
70 to 74 without cancer |
3 |
|
|
75 to 79 without cancer |
4 |
|
|
80 to 84 without cancer |
5 |
|
|
85 to 89 without cancer |
6 |
|
|
90 to 94 without cancer |
7 |
|
|
95 to 99 without cancer |
8 |
|
|
>= 100 without cancer |
9 |
|
|
< 70 with cancer |
20 |
|
|
70 to 74 with cancer |
19 |
|
|
75 to 79 with cancer |
18 |
|
|
80 to 84 with cancer |
17 |
|
|
85 to 89 with cancer |
19 |
|
|
90 to 94 with cancer |
15 |
|
|
95 to 99 with cancer |
14 |
|
|
>= 100 with cancer |
13 |
|
unintended weight loss |
no |
0 |
|
|
yes |
5 |
|
renal failure |
no |
0 |
|
|
yes |
6 |
|
heart failure |
no |
0 |
|
|
yes |
4 |
|
poor appetite |
no |
0 |
|
|
yes |
4 |
|
shortness of breath at rest |
no |
0 |
|
|
yes |
8 |
|
living independent |
yes |
0 |
|
|
no |
8 |
subscore for first 9 parameters =
= SUM(points for first 9 parameters)
|
Parameter |
Finding |
Points |
|
mobility/locomotion |
independent |
0 |
|
|
supervised |
1 |
|
|
limited assistance |
2 |
|
|
extensive assistance |
3 |
|
|
total dependence |
4 |
|
eating |
independent |
0 |
|
|
supervised |
1 |
|
|
limited assistance |
2 |
|
|
extensive assistance |
3 |
|
|
total dependence |
4 |
|
toilet use |
independent |
0 |
|
|
supervised |
1 |
|
|
limited assistance |
2 |
|
|
extensive assistance |
3 |
|
|
total dependence |
4 |
|
personal hygiene |
independent |
0 |
|
|
supervised |
1 |
|
|
limited assistance |
2 |
|
|
extensive assistance |
3 |
|
|
total dependence |
4 |
subscore for activities of daily living =
= SUM(points for the 4 parameters)
|
Parameters |
Finding |
Points |
|
cognitive decline |
no |
0 |
|
|
yes and ADL 0 |
-2 |
|
|
yes and ADL 1 or 2 |
-1 |
|
|
yes and ADL 3 or 4 |
0 |
|
|
yes and ADL 5 to 7 |
1 |
|
|
yes and ADL 8 or 9 |
2 |
|
|
yes and ADL 10 or 11 |
3 |
|
|
yes and ADL 12 or 13 |
4 |
|
|
yes and ADL 14 to 16 |
5 |
total score =
= (subscore for first 9 parameters) + (subscore for ADL) + (points for cognitive decline)
Interpretation:
• minimum score: 0
• maximum score: 81
• The higher the score the greater the patient's frailty.
• If the score is determined prospectively, then the score is designated RAI-C.
• If the score is determined retrospectively, then the score is designated RAI-A.
|
Score |
Group |
|
0 to 15 |
1 |
|
16 to 25 |
2 |
|
26 to 35 |
3 |
|
>= 36 |
4 |
Performance:
• The area under the ROC curve is 0.82.
