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Multidimensional frailty score for the prediction of postoperative mortality risk
Kim SW, Han HS, Jung HW, Kim KI, Hwang DW, Kang SB, Kim CH.. JAMA surgery, 2014-07-01
Topic: Risk, prevention and care in population studies
Importance The number of geriatric patients who undergo surgery has been increasing, but there are insufficient tools to predict postoperative outcomes in the elderly. Objective To design a predictive model for adverse outcomes in older surgical patients. Design, setting, and participants From October 19, 2011, to July 31, 2012, a single tertiary care center enrolled 275 consecutive elderly patients (aged ≥65 years) undergoing intermediate-risk or high-risk elective operations in the Department of Surgery. Main outcomes and measures The primary outcome was the 1-year all-cause mortality rate. The secondary outcomes were postoperative complications (eg, pneumonia, urinary tract infection, delirium, acute pulmonary thromboembolism, and unplanned intensive care unit admission), length of hospital stay, and discharge to nursing facility. Results Twenty-five patients (9.1%) died during the follow-up period (median [interquartile range], 13.3 [11.5-16.1] months), including 4 in-hospital deaths after surgery. Twenty-nine patients (10.5%) experienced at least 1 complication after surgery and 24 (8.7%) were discharged to nursing facilities. Malignant disease and low serum albumin levels were more common in the patients who died. Among the geriatric assessment domains, Charlson Comorbidity Index, dependence in activities of daily living, dependence in instrumental activities of daily living, dementia, risk of delirium, short midarm circumference, and malnutrition were associated with increased mortality rates. A multidimensional frailty score model composed of the above items predicted all-cause mortality rates more accurately than the American Society of Anesthesiologists classification (area under the receiver operating characteristic curve, 0.821 vs 0.647; P = .01). The sensitivity and specificity for predicting all-cause mortality rates were 84.0% and 69.2%, respectively, according to the model's cutoff point (>5 vs ≤5). High-risk patients (multidimensional frailty score >5) showed increased postoperative mortality risk (hazard ratio, 9.01; 95% CI, 2.15-37.78; P = .003) and longer hospital stays after surgery (median [interquartile range], 9 [5-15] vs 6 [3-9] days; P Conclusions and relevance The multidimensional frailty score based on comprehensive geriatric assessment is more useful than conventional methods for predicting outcomes in geriatric patients undergoing surgery.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Kim, S. W., Han, H. S., Jung, H. W., Kim, K. I., Hwang, D. W., Kang, S. B., et al. (2014). Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA surgery. https://doi.org/10.1001/jamasurg.2014.241
Vancouver
Kim SW, Han HS, Jung HW, Kim KI, Hwang DW, Kang SB, et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA surgery. 2014. doi:10.1001/jamasurg.2014.241. PMID: 24804971.
BibTeX
@article{kim2014-24804971,
author = {Kim, S. W. and Han, H. S. and Jung, H. W. and Kim, K. I. and Hwang, D. W. and Kang, S. B. and Kim, C. H.},
title = {{Multidimensional frailty score for the prediction of postoperative mortality risk}},
journal = {JAMA surgery},
year = {2014},
doi = {10.1001/jamasurg.2014.241},
pmid = {24804971},
url = {https://doi.org/10.1001/jamasurg.2014.241}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results Twenty-five patients (9.1%) died during the follow-up period (median [interquartile range], 13.3 [11.5-16.1] months), including 4 in-hospital deaths after surgery.
- Among the geriatric assessment domains, Charlson Comorbidity Index, dependence in activities of daily living, dependence in instrumental activities of daily living, dementia, risk of delirium, short midarm circumference, and malnutrition were associated with increased mortality rates.
Why it matters
This study designed a predictive model for adverse outcomes in older surgical patients and found that dementia, among other geriatric assessment domains, was associated with increased mortality rates. It concerns predicting postoperative mortality risk, not treating, curing or preventing Alzheimer's disease.
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Study details
- Participants275
- Effect size9.1%; 10.5%; 8.7%
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (JAMA surgery) |
| Journal's citation record | 2 / 4 | JAMA Surgery: journal h-index 185 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 275 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 416 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 29.7 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 4 / 6 | Cited 18.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 3 / 4 | Cited 63 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Cheol‐Ho Kim: h-index 32 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Seoul National University: institution h-index 1,053 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24804971) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 52 / 100 | — |
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