Table 6.
Mortality Odds Ratios Adjusted for Sex, RAI, OSS, Case Status, CDIV and PASC with Sex*PASC Interaction Term or PASC Subgroup Analyses
| 30-day | 90-day | 180-day | ||||
|---|---|---|---|---|---|---|
| Adjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
| Sex*PASC Interaction Term Analysis (n=82,269) | ||||||
| Male (Ref = Female) | 0.88 (0.75–1.04) | .13 | 0.92 (0.81–1.05) | .21 | 0.94 (0.85–1.05) | .27 |
| RAI (Ref = Normal 21–29) | ||||||
| Robust (≤20) | 0.25 (0.21–0.30) | <.001 | 0.22 (0.19–0.26) | <.001 | 0.21 (0.19–0.24) | <.001 |
| Frail (30–39) | 2.45 (2.10–2.86) | <.001 | 2.96 (2.61–3.36) | <.001 | 3.20 (2.87–3.57) | <.001 |
| Very frail (≥40) | 4.60 (3.51–6.03) | <.001 | 5.64 (4.50–7.09) | <.001 | 6.17 (5.03–7.57) | <.001 |
| Expanded OSS (Ref = OSS1) | ||||||
| OSS2 | 1.74 (0.89–3.40) | .11 | 1.43 (0.89–2.32) | .14 | 1.63 (1.07–2.48) | .02 |
| OSS3 | 2.52 (1.30–4.86) | .006 | 2.01 (1.26–3.23) | .004 | 2.16 (1.43–3.26) | <.001 |
| OSS4 | 3.18 (1.64–6.18) | .001 | 2.70 (1.67–4.35) | <.001 | 3.03 (1.99–4.59) | <.001 |
| OSS5 | 6.51 (3.21–13.21) | <.001 | 4.75 (2.82–8.01) | <.001 | 6.57 (4.19–10.31) | <.001 |
| Urgent/Emergent (Ref = elective) | 4.08 (3.48–4.79) | <.001 | 3.79 (3.35–4.29) | <.001 | 3.22 (2.90–3.56) | <.001 |
| CDIV | 15.50 (13.49–17.81) | <.001 | 12.13 (10.74–13.69) | <.001 | 9.30 (8.31–10.41) | <.001 |
| PASC | 3.50 (2.82–4.35) | <.001 | 3.28 (2.71–3.96) | <.001 | 3.08 (2.58–3.67) | <.001 |
| Males*PASC | 0.75 (0.56–0.989) | .04 | 0.73 (0.57–0.93) | .01 | 0.71 (0.56–0.89) | .003 |
| Model C-statistic | 0.95 | 0.93 | 0.95 | |||
| Subgroup Analyses | ||||||
| PASC subgroup (n=3,492) | ||||||
| Male (Ref = Female) | 0.76 (0.61–0.93) | .009 | 0.76 (0.62–0.92) | .006 | 0.74 (0.62–0.90) | .002 |
| RAI (Ref = Normal 21–29) | ||||||
| Robust (≤20) | 0.31 (0.23–0.41) | <.001 | 0.30 (0.23–0.39) | <.001 | 0.30 (0.24–0.39) | <.001 |
| Frail (30–39) | 1.89 (1.47–2.44) | <.001 | 2.40 (1.89–3.05) | <.001 | 2.42 (1.92–3.05) | <.001 |
| Very frail (≥40) | 2.64 (1.80–3.88) | <.001 | 3.10 (2.14–4.50) | <.001 | 3.46 (2.39–4.99) | <.001 |
| Expanded OSS (Ref = OSS1) | ||||||
| OSS2 | 2.75 (0.83–9.12) | .10 | 2.27 (0.87–5.88) | .09 | 2.87 (1.11–7.39) | .03 |
| OSS3 | 4.45 (1.37–14.47) | .01 | 3.43 (1.34–8.74) | .01 | 4.18 (1.65–10.63) | .003 |
| OSS4 | 5.43 (1.66–17.72) | .005 | 4.78 (1.87–12.24) | .001 | 5.69 (2.23–14.50) | <.001 |
| OSS5 | 3.56 (0.79–15.97) | .10 | 5.26 (1.55–17.79) | .008 | 6.19 (1.86–20.60) | .003 |
| Urgent/Emergent (Ref = elective) | 3.07 (1.88–5.01) | <.001 | 2.49 (1.67–3.71) | <.001 | 2.07 (1.45–2.95) | <.001 |
| CDIV | 4.73 (3.82–5.84) | <.001 | 4.66 (3.82–5.70) | <.001 | 4.37 (3.60–5.31) | <.001 |
| Model C-Statistic | 0.82 | 0.82 | 0.82 | |||
| No PASC subgroup (n=78,777) | ||||||
| Male (Ref = Female) | 0.82 (0.70–0.97) | .02 | 0.88 (0.78–1.01) | .06 | 0.91 (0.82–1.02) | .10 |
| RAI (Ref = Normal 21–29) | ||||||
| Robust (≤20) | 0.24 (0.19–0.30) | <.001 | 0.21 (0.17–0.25) | <.001 | 0.20 (0.17–0.23) | <.001 |
| Frail (30–39) | 2.61 (2.15–3.16) | <.001 | 3.08 (2.65–3.57) | <.001 | 3.37 (2.98–3.81) | <.001 |
| Very frail (≥40) | 6.56 (4.63–9.29) | <.001 | 7.38 (5.63–9.68) | <.001 | 7.56 (5.97–9.57) | <.001 |
| Expanded OSS (Ref = OSS1) | ||||||
| OSS2 | 1.38 (0.62–3.05) | .43 | 1.22 (0.71–2.11) | .48 | 1.40 (0.88–2.21) | .15 |
| OSS3 | 1.88 (0.86–4.10) | .11 | 1.66 (0.97–2.84) | .06 | 1.80 (1.15–2.83) | .01 |
| OSS4 | 2.26 (1.02–5.00) | .04 | 2.09 (1.21–3.62) | .008 | 2.47 (1.56–3.92) | <.001 |
| OSS5 | 4.98 (2.18–11.36) | <.001 | 3.75 (2.09–6.75) | <.001 | 5.51 (3.38–9.00) | <.001 |
| Urgent/Emergent (Ref = elective) | 3.87 (3.25–4.59) | <.001 | 3.76 (3.29–4.29) | <.001 | 3.22 (2.89–3.59) | <.001 |
| CDIV | 29.54 (24.90–35.04) | <.001 | 18.73 (16.22–21.63) | <.001 | 12.64 (11.07–14.43) | <.001 |
| Model C-Statistic | 0.94 | 0.92 | 0.89 | |||
Abbreviations: CDIV, Clavien-Dindo IV complications; OR, Odds Ratio; OSS, Operative Stress Score; PASC, Preoperative Acute Serious Conditions; RAI, Risk Analysis Index; Ref, reference.
Logistic regression analyses