Evidence map›Paper›PMID 28265844›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017

Frailty as a Risk Predictor of Morbidity and Mortality Following Liver Surgery.

Faiz Gani, Marcelo Cerullo, Neda Amini, Stefan Buettner, Georgios A Margonis, Kazunari Sasaki, Yuhree Kim, Timothy M Pawlik

Abstract readValidation Study
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In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  16. Timing and Severity of Postoperative Complications and Associated 30-Day Mortality Following Hepatic Resection: a National Surgical Quality Improvement Project Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Faiz GaniDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Marcelo CerulloDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neda AminiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stefan BuettnerDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Georgios A MargonisDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kazunari SasakiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Yuhree KimDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Timothy M PawlikDepartment of Surgery, Wexner Medical Center at The Ohio State University, Columbus, OH, USA. tim.pawlik@osumc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGiven the increasing number of elderly and comorbid patients undergoing surgery, there is increased interest in preoperatively identifying patients at high risk of morbidity and mortality following liver resection. We sought to develop and validate the use of a frailty index (FI) to predict poor postoperative outcomes following liver surgery.

methodsPatients undergoing a liver resection were identified using the National Surgical Quality Improvement Program Hepatectomy-targeted database for 2014 and randomized into a training or validation cohort. Multivariable logistic regression analysis was performed to develop a revised frailty index (rFI) to predict adverse postoperative clinical outcomes. Leave one out cross-validation was performed to validate the proposed rFI.

resultsA total of 2714 patients were identified who met the inclusion criteria. Postoperatively, 826 patients (30.4%) developed a postoperative complication, while 39 patients died within 30 days of surgery. Five preoperative variables (ASA class, BMI, serum albumin, hematocrit, underlying pathology, and type of liver resection) were used to develop the rFI. The rFI demonstrated good discrimination (AUROC = 0.68) and outperformed the previously proposed modified frailty index (mFI; AUROC = 0.53, p < 0.001) when evaluated among patients included in the training cohort. On validation, the rFI demonstrated good model discrimination (AUROC = 0.68) and was accurately able to risk-stratify patients within the validation cohort at risk for developing a postoperative complication, prolonged length-of-stay, and postoperative mortality (all p < 0.05).

conclusionFrailty, as measured by the rFI, was predictive of increased risk of morbidity and mortality following liver surgery and can be used to guide patient decision-making.

Indexed as

Frail ElderlyHealth Status IndicatorsAgedComorbidityDatabases, FactualFemaleHepatectomyHumansLength of StayLiverMaleMiddle AgedPostoperative ComplicationsPrognosisRetrospective StudiesRisk AssessmentFrailtyHepatic surgeryLiverMorbidityMortalityPrediction

Identifiers

PMID28265844

What OpenQuestion holds

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Registered trials

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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.