Association of American Society of Anesthesiology and Modified Charlson Comorbidty Index Scores with Survival in Geriatric Patients Undergoing Thoracic Surgery

Objective: We aimed to evaluate the relationship between preoperative American Society of Anesthesiology and Modified Charlson Comorbidty Index scores and postoperative survival in geriatric patients who had undergone thoracic surgery.
Methods: A total of 109 patients aged 65 years and above who had undergone thoracic surgery under elective conditions were included in this retrospective study.
Results: Patients who died within the first postoperative two years had higher American Society of Anesthesiology III–IV scores (p=0.03), higher Modified Charlson Comorbidty Index scores (p=0.04), and lower hemoglobin and hematocrit values (p=0.02 and p=0.005, respectively). We found that Modified Charlson Comorbidty Index was significantly effective in predicting two-year mortality among geriatric patients (AUC = 0.648, 95% CI: 0.516–0.780, p=0.02). In the ROC analysis, the best predictive cut-off value for Modified Charlson Comorbidty Index was found to be 7 (sensitivity: 79.7%, and specificity: 44.4%).
Conclusion: The cautious choice of patients for the medical procedure has contributed to the improvement in mortality rates after some time, and with refinements in preoperative testing meticulous patient selection should be maintained.

Torasik Cerrahi Geçiren Geriatrik Hastalarda Amerikan Anestezistler Derneði ve Modifiye Charlson Komorbidite Skorlarýnýn Saðkalým Deðerlendirmesi

Amaç: Torasik cerrahi geçirmiþ geriyatrik hastalarýn preoperatif American Society of Anesthesiology ve Modified Charlson Comorbidty Index skorlarý ile postoperatif saðkalým arasýndaki iliþkiyi deðerlendirmeyi amaçladýk.
Yöntem: Bu retrospektif çalýþmaya elektif koþullarda göðüs cerrahisi geçirmiþ 65 yaþ ve üzeri 109 hasta dahil edildi.
Bulgular: Ýlk iki yýl içinde ölen hastalarýn daha yüksek American Society of Anesthesiology III-IV skorlarý (p=0.03), daha yüksek Modified Charlson Comorbidty Index skorlarý (p=0.04) ve daha düþük hemoglobin ve hematokrit deðerleri (sýrasýyla p=0.02 ve p=0.005) vardý. Geriyatrik hastalar arasýnda Modified Charlson Comorbidty Index skorlarýnýn iki yýllýk mortaliteyi öngörmede anlamlý derecede etkili olduðunu bulduk (AUC=0.648,% 95 CI: 0.516-0.780, p=0.02). ROC analizinde, Modified Charlson Comorbidty Index için en iyi kestirim deðeri 7 olarak bulundu (duyarlýlýk: %79.7, özgüllük: %44.4).
Tartýþma: Cerrahi prosedür için hastalarýn dikkatli seçimi, ileride mortalitede iyileþmeye katkýda bulunabilir. Preoperatif testlerdeki iyileþtirmeler ile ayrýntýlý hasta seçimi yapýlmaya devam edilmelidir.