Table. Mortality at 180 Days Postoperatively by Level of Operative Stress.
| Frailty stratum and operative urgency | Mortality rate, mean (95% CI), % | P value for OSSa | ||||
|---|---|---|---|---|---|---|
| OSS 1 | OSS 2 | OSS 3 | OSS 4 | OSS 5 | ||
| Robust (RAI ≤20) | ||||||
| All (n = 199 677) | 0.54 (0.44-0.65) | 0.43 (0.39-0.46) | 1.03 (0.94-1.12) | 2.69 (2.37-3.04) | 5.93 (4.23-8.05) | <.001 |
| Elective (n = 192 369) | 0.52 (0.42-0.63) | 0.39 (0.36-0.43) | 0.91 (0.83-1.00) | 2.59 (2.27-2.95) | 5.88 (4.06-8.20) | <.001 |
| Emergent (n = 7308) | 1.20 (0.44-2.59) | 1.56 (1.18-2.02) | 3.17 (2.52-3.92) | 4.37 (2.76-6.55) | 6.19 (2.30-12.98) | <.001 |
| Normal (RAI 21-29) | ||||||
| All (n = 187 459) | 1.97 (1.78-2.17) | 1.45 (1.37-1.53) | 3.29 (3.15-3.44) | 5.78 (5.41-6.18) | 8.61 (7.29-10.08) | <.001 |
| Elective (n = 179 871) | 1.90 (1.72-2.10) | 1.35 (1.27-1.42) | 2.87 (2.73-3.01) | 5.31 (4.94-5.70) | 8.26 (6.91-9.76) | <.001 |
| Emergent (n = 7588) | 5.41 (3.42-8.07) | 5.24 (4.38-6.21) | 9.45 (8.54-10.42) | 13.05 (10.90-15.46) | 12.90 (7.56-20.11) | <.001 |
| Frail (RAI 30-39) | ||||||
| All (n = 36 579)b | 9.40 (8.54-10.32) | 9.19 (8.68-9.72) | 16.22 (15.65-16.80) | 18.03 (16.83-19.28) | 18.43 (15.04-22.23) | <.001 |
| Elective (n = 32 060)b | 9.14 (8.27-10.06) | 8.45 (7.93-8.90) | 14.85 (14.25-15.46) | 14.88 (13.65-16.18) | 19.01 (15.31-23.18) | <.001 |
| Emergent (n = 4519)b | 15.70 (10.61-22.01) | 17.74 (15.36-20.33) | 23.41 (21.78-25.09) | 31.04 (27.76-34.47) | 14.93 (7.40-25.74) | <.001 |
| Very frail (RAI ≥40) | ||||||
| All (n = 9113)b | 34.91 (30.58-39.44) | 31.92 (29.68-34.21) | 43.00 (41.69-44.32) | 41.97 (39.23-44.75) | 17.10 (12.07-23.17) | .001 |
| Elective (n = 6780)b | 33.33 (28.74-38.18) | 29.15 (26.76-31.64) | 40.20 (38.69-41.73) | 34.10 (30.78-37.55) | 14.29 (9.17-20.83) | .24 |
| Emergent (n = 2333)b | 45.16 (32.48-58.32) | 44.63 (38.90-50.47) | 50.82 (48.22-53.42) | 54.81 (50.23-59.34) | 28.21 (15.00-44.87)c | .11 |
Abbreviations: OSS, Operative Stress Score; and RAI, Risk Analysis Index.
a
χ2 test for trend.
b
All P values for trend across frailty are <.001 except where noted otherwise (χ2 test for trend).
c
P = .001 (χ2 test for trend).