Table 1. Modifications to the Surgical Serious Illness Consensus Definition and Relevant Data Sources.

Criterion No.	Lee et al15 definitiona	Adapted definition
1	ASA risk score: class IV or V	No modification(s)b
2	Vulnerable elder (adult aged >84 y or adult aged >64 y with any functional or cognitive disability)	Vulnerable elder (adult aged >84 y or adult aged >64 y with functionally dependent health status or history of stroke or CVA or of dementia)c
3	Advanced cancer (stage III or IV solid cancers and hematologic malignancies) and ≥1 hospitalization in prior year	Disseminated cancerc
4	Oxygen-dependent pulmonary disease	COPDc
5	CHF with any all-cause hospitalization or ≥2 ED visits in past 6 mo	CHFc
6	Cirrhosis with any CTP class or MELD score	No modification(s)c
7	ESKD on dialysis or eligible for dialysis	No modification(s)c
8	Dementia with impaired daily function and ≥1 hospitalization in prior year	Dementiac
9	Frailty (left undefined)	≥2 Points on the modified 5-item Frailty Indexd
10	Trauma with: (1) severe TBI with an AIS score ≥3, or a GCS score of 3-8; or (2) critical injury (ISS >25 and/or >24-h ICU admission)	No modification(s)c
11	Nursing home resident	Admitted from skilled nursing facilityb

Abbreviations: AIS, Abbreviated Injury Scale; ASA, American Society of Anesthesiologists; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CTP, Child-Turcotte-Pugh; CVA, cerebrovascular accident; ED, emergency department; ESKD, end-stage kidney disease; GCS, Glasgow Coma Scale; ICU, intensive care unit; ISS, Injury Severity Score; MELD, Model for End-Stage Liver Disease; TBI, traumatic brain injury.

^a The use of italics for some words indicates that these original qualifiers were removed in the adapted definition.

^b Additional medical record review or abstraction required outside of the trauma registry or National Trauma Data Bank (NTDB).

^c NTDB-defined field(s).

^d The Frailty Index is based on National Surgical Quality Improvement Program data and gives 1 point each for COPD, CHF, dependent functional status, hypertension requiring medication, and diabetes.