Preoperative health status assessed with different scales and postoperative cardiac and cerebrovascular complications in older patients

作者：Shiyi Han, Fan Li, Duo Hou, Xuecai Lv, Haoyun Zhang, Saisong Xiao, Jingsheng Lou, Hao Li, Jiangbei Cao, 王迪芬, Xiaoping Gu, Yuming Peng, Yubo Xie, Yi Feng, Qingping Wu, Junmei Xu, Mi Wd, Yanhong Liu · 发表于：European Journal of Anaesthesiology · 年份：2026 · DOI：10.1097/eja.0000000000002432 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Enhanced Recovery After Surgery、Frailty in Older Adults

BACKGROUND: Multiple scales are available to evaluate the health status of older surgical patients; however, their relative ability to predict postoperative major adverse cardiac and cerebrovascular events (MACCE) remains unclear. OBJECTIVE: To examine the association between preoperative health status, as measured by four commonly used scales, and 30-day postoperative MACCE in older surgical patients, and to compare their predictive performance and incremental value against the Revised Cardiac Risk Index (RCRI). DESIGN: A retrospective study of a large multicentre cohort. SETTING: Nineteen tertiary hospitals across China participating in a perioperative database. PATIENTS: Patients aged ≥65 years who underwent noncardiac, non-neurosurgical surgery between April 2020 and April 2022 were included in the analysis. The Activities of Daily Living (ADL), EuroQol Five-Dimension Five-Level (EQ-5D-5L), Metabolic Equivalent of Task (MET), FRAIL, and RCRI were evaluated preoperatively. MAIN OUTCOME MEASURE: The primary outcome was the occurrence of MACCE within 30 days after surgery, defined as any of the following: stroke, myocardial infarction, angina pectoris, congestive heart failure, cardiac arrest, or all-cause mortality. RESULTS: Among the 7996 patients, 126 (1.6%) experienced MACCE. Similar to the RCRI, the four health assessments were significantly associated with MACCE risk. The RCRI alone yielded an area under the curve (AUC) of 0.610 [95% confidence interval (CI): 0.563 to ...