Evidence map›Paper›PMID 38445911›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2024

Association of risk analysis index with 90-day failure to rescue following major abdominal surgery in geriatric patients.

Grant N Sutherland, Christopher L Cramer, Paul W Clancy Iii, Minghui Huang, Lena M Turkheimer, Christine A Tran, Florence E Turrentine, Victor M Zaydfudim

Open access · greenAbstract read
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 22% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Grant N SutherlandSchool of Medicine, University of Virginia, Charlottesville, Virginia, United States.
Christopher L CramerDivision of Surgical Oncology, Department of Surgery, University of Virginia Health, Charlottesville, Virginia, United States; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia, United States.
Paul W Clancy IiiSchool of Medicine, University of Virginia, Charlottesville, Virginia, United States.
Minghui HuangSchool of Medicine, University of Virginia, Charlottesville, Virginia, United States.
Lena M TurkheimerDivision of Surgical Oncology, Department of Surgery, University of Virginia Health, Charlottesville, Virginia, United States; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia, United States.
Christine A TranDivision of Surgical Oncology, Department of Surgery, University of Virginia Health, Charlottesville, Virginia, United States; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia, United States.
Florence E TurrentineDivision of Surgical Oncology, Department of Surgery, University of Virginia Health, Charlottesville, Virginia, United States; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia, United States.
Victor M ZaydfudimDivision of Surgical Oncology, Department of Surgery, University of Virginia Health, Charlottesville, Virginia, United States; Surgical Outcomes Research Center, University of Virginia, Charlottesville, Virginia, United States. Electronic address: vz8h@virginia.edu.
University of Virginia · US

Funding

Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
NCI NIH HHS L30 CA220861NCI NIH HHS T32 CA163177
6 · The paper itself

Abstract

backgroundFailure to rescue (FTR) is a quality metric defined as mortality after potentially preventable complications after surgery. Predicting patients who are at the highest risk of mortality after a complication may aid in preventing deaths. Thirty-day follow-up period inadequately captures postoperative deaths; alternatively, a 90-day follow-up period has been advocated. This study aimed to examine the association of a validated frailty metric, the risk analysis index (RAI), with 90-day FTR (FTR-90).

methodsPatients aged ≥65 years who underwent a major abdominal operation between 2014 and 2020 at a quaternary care center were abstracted. Institutional data were merged with the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and Geriatric Surgery Research File variables. The association between RAI and FTR-90 was evaluated using multivariable logistic regression.

resultsA total of 398 patients with postoperative complications were included. Fifty-two patients (13.1%) died during the 90-day follow-up. The FTR-90 group was older (median age: 76 vs 73 years, respectively; P = .002), had a greater preoperative American Society of Anesthesiologists classification score (P < .001), and had a higher ACS NSQIP estimated risk of morbidity (0.33% vs 0.20%, P < .001) and mortality (0.067% vs 0.012%, P < .001). The FTR-90 group had a greater median RAI score (23 vs 19; P = .002). The RAI score was independently associated with FTR-90 (odds ratio, 1.04; 95% CI, 1.0042-1.0770; P = .028) but not with FTR-30 (P = .13).

conclusionPreoperative frailty, as defined by RAI, is independently associated with FTR at 90-day follow-up. FTR-90 captured nearly 60% more deaths than did FTR-30. Frailty has major implications beyond the typical 30-day follow-up period, and a longer follow-up period must be considered.

Indexed as

FrailtyAbdomenAgedHumansOdds RatioPostoperative ComplicationsQuality ImprovementFailure to rescueFrailtyGeriatricMajor abdominal surgeryRisk analysis index

Identifiers

PMID38445911
PMCPMC12860453
OpenAlexW4391066281

What OpenQuestion holds

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Registered trials

None linked

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.