ArticleBMC anesthesiology2022
The composite risk index based on frailty predicts postoperative complications in older patients recovering from elective digestive tract surgery: a retrospective cohort study.
Article in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Trends and development in perioperative enteral nutrition: a systematic bibliometric analysis.Frontiers in nutrition · 2024Pooled it
- Evaluating the impact of a modified multi-modal prehabilitation program on perioperative outcomes in Chinese patients undergoing colorectal cancer surgery.Frontiers in surgery · 2026Trial
- Efficacy and safety of ciprofol for general anesthesia induction in female patients with frailty: a prospective randomized controlled trial.BMC anesthesiology · 2024Trial
- The impact of frailty and sarcopenia index on postoperative nausea and vomiting in elderly patients undergoing sedation-assisted gastrointestinal endoscopy.BMC anesthesiology · 2026Article
- Development and Validation of a Robust Prediction Model for Postoperative Pneumonia in Elderly Patients with Hip Fracture: Integrating Frailty, Nutrition, and Comprehensive Risk Assessment.Risk management and healthcare policy · 2026Article
- Assessing combined effects of risk analysis index-revised (RAI-rev), malnutrition, and anemia on morbidity and mortality after spine surgery for metastatic spinal tumors.Journal of neuro-oncology · 2025Article
- Composite RAI, Malnutrition, and Anemia Model Superiorly Predicts 30-Day Morbidity and Mortality After Surgery for Adult Spinal Deformity.Journal of clinical medicine · 2025Article
- Comparison of two frailty indices in predicting life-threatening morbidity and mortality among older patients undergoing elective high-risk abdominal surgery.Frontiers in public health · 2023Article
- A systematic review of predictive accuracy via c-statistic of preoperative frailty tests for extended length of stay, post-operative complications, and mortality.Saudi journal of anaesthesiaReview
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLimitations exist in available studies investigating effect of preoperative frailty on postoperative outcomes. This study was designed to analyze the association between composite risk index, an accumulation of preoperative frailty deficits, and the risk of postoperative complications in older patients recovering from elective digestive tract surgery.
methodsThis was a retrospective cohort study. Baseline and perioperative data of older patients (age ≥ 65 years) who underwent elective digestive tract surgery from January 1, 2017 to December 31, 2018 were collected. The severity of frailty was assessed with the composite risk index, a composite of frailty deficits including modified frailty index. The primary endpoint was the occurrence of postoperative complications during hospital stay. The association between the composite risk index and the risk of postoperative complications was assessed with a multivariable logistic regression model.
resultsA total of 923 patients were included. Of these, 27.8% (257) developed postoperative complications. Four frailty deficits, i.e., modified frailty index ≥0.27, malnutrition, hemoglobin < 90 g/L, and albumin ≤30 g/L, were combined to generate a composite risk index. Multivariable analysis showed that, when compared with patients with composite risk index of 0, the odds ratios (95% confidence intervals) were 2.408 (1.714-3.383, P < 0.001) for those with a composite risk index of 1, 3.235 (1.985-5.272, P < 0.001) for those with a composite risk index of 2, and 9.227 (3.568-23.86, P < 0.001) for those with composite risk index of 3 or above. The area under receiver-operator characteristic curve to predict postoperative complications was 0.653 (95% confidence interval 0.613-0.694, P < 0.001) for composite risk index compared with 0.622 (0.581-0.663, P < 0.001) for modified frailty index.
conclusionFor older patients following elective digestive tract surgery, high preoperative composite risk index, a combination of frailty deficits, was independently associated with an increased risk of postoperative complications.
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