Observational studyMedicine2015
Association of comorbidities with postoperative in-hospital mortality: a retrospective cohort study.
Observational study in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- A Novel Tool for Predicting Major Complications After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy.Annals of surgical oncology · 2016Trial
- Emergency Cholecystectomy in Patients Classified as High Risk According to the Tokyo Guidelines 2018: A Real-World Analysis.Annals of gastroenterological surgery · 2026Article
- Hip and knee arthroplasty in solid organ transplant patients: Results from a Turkish government-based health registry.Acta orthopaedica et traumatologica turcica · 2025Article
- Machine learning-based hybrid risk estimation system (ERES) in cardiac surgery: Supplementary insights from the ASA score analysis.PLOS digital health · 2025Article
- Comparing Charlson Comorbidity Index Scores between Anesthesiologists, Patients, and Administrative Data: A Prospective Observational Study.Journal of clinical medicine · 2024Article
- Magnitude of post-operative mortality and associated factors among patients who underwent surgery in Wolaita Sodo teaching and referral hospital, SNNPR region, Ethiopia.African health sciences · 2021Article
- Developing a Simpler Prognosticating Tool: Comparing the Combined Assessment of Risk Encountered in Surgery Score with Deyo-Charlson Comorbidity Index and The American Society of Anesthesiologists Physical Status Score in Predicting 2 years Mortality after Hip Fracture Surgery.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- RoboticWorld journal of gastrointestinal surgery · 2020Article
- Observational
- Article
- Risk stratification tools in emergency general surgery.Trauma surgery & acute care open · 2018Review
- Age-adjusted Charlson comorbidity index score as predictor of survival of patients with digestive system cancer who have undergone surgical resection.Oncotarget · 2017Article
- Age, American Society of Anesthesiologists physical status classification and Charlson score are independent predictors of 90-day mortality after radical cystectomy.World journal of urology · 2016Article
- Perioperative Blood Transfusion is Associated with an Increased Mortality in Older Surgical Patients.World journal of surgery · 2016Article
- Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.Medicine · 2016Observational
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of this article is to evaluate the American Society of Anesthesiologists Physical Status (ASA PS) and the Charlson comorbidity index (CCI) for the prediction of postoperative mortality. The ASA PS has been suggested to be equally good as the CCI in predicting postoperative outcome. However, these scores have never been compared in a broad surgical population. We conducted a retrospective cohort study in a German tertiary care university hospital. Predictive accuracy was compared using the area under the receiver-operating characteristic curves (AUROC). In a post hoc approach, a regression model was fitted and cross-validated to estimate the association of comorbidities and intraoperative factors with mortality. This model was used to improve prediction by recalibrating the CCI for surgical patients (sCCIs) and constructing a new surgical mortality score (SMS). The data of 182,886 patients with surgical interventions were analyzed. The CCI was superior to the ASA PS in predicting postoperative mortality (AUROCCCI 0.865 vs AUROCASAPS 0.833, P < 0.001). Predictive quality further improved after recalibration of the sCCI and construction of the new SMS (AUROCSMS 0.928 vs AUROCsCCI 0.896, P < 0.001). The SMS predicted postoperative mortality especially well in patients never admitted to an intensive care unit. The newly constructed SMS provides a good estimate of patient's risk of death after surgery. It is capable of identifying those patients at especially high risk and may help reduce postoperative mortality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.