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Impact of Co-morbidites, Physiological Status and Age on Survival

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Perioperative Medicine – Current Controversies

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Abstract

This chapter describes the preoperative calculation of survival, illustrating how the historical failure to generate appropriate postoperative survival curves has led to bad practice for scheduled repair of abdominal aortic aneurysm. Survival in the general population, including patients who have had surgery, can be modelled using published mortality rates specific for year, age and sex, adjusted as necessary for morbidity, fitness and the transient effects of surgery. The mortality hazard is a proxy for quality of life – people more likely to die are less likely to have a good quality of life: it therefore serves as an indicator of life as well as death, until we have more information about how patients live after surgery.

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References

  1. Nightingale F (1859) Notes on hospitals, 1st edn. Longman, Green, Longman, Roberts and Green, London

    Google Scholar 

  2. Office for National Statistics. Statistical bulletin: Interim life tables, England and Wales, 2010–12. http://www.ons.gov.uk/ons/rel/lifetables/interim-life-tables/2010-2012/stbilt2012.html. Accessed 12/06/2015

  3. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Article  Google Scholar 

  4. Carlisle JB, Danjoux G, Kerr K, Snowden C, Swart M (2015) Validation of long-term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre-operative variables. Anaesthesia 70:654–665

    Article  CAS  PubMed  Google Scholar 

  5. Moonesinghe SR, Mythen MG, Das P, Rowan KM, Grocott MPW (2013) Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery. Anesthesiology 119:959–981

    Article  PubMed  Google Scholar 

  6. Grant SW, Hickey GL, Carlson ED, McCollum CN (2014) Comparison of three contemporary risk scores for mortality following elective abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg 48:38–44

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Lee TH, Marcantonio ER, Mangione CM et al (1999) Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 100:1043–1049

    Article  CAS  PubMed  Google Scholar 

  8. Protopapa KL, Simpson JC, Smith NCE, Moonesinghe SR (2014) Development and validation of the surgical outcome risk tool (SORT). Br J Surg 101:1774–1783

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Fox KAA, Carruthers KF, Dunbar DR et al (2010) Underestimated and under-recognized: the late consequences of acute coronary syndrome (GRACE UK-Belgian Study). Eur Heart J 31:2755–2764

    Article  PubMed  Google Scholar 

  10. Brindle P, Beswick A, Fahey T et al (2006) Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart 92:1752–1759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Wannamethee SG, Sharper AG, Lennon L (2004) Cardiovascular disease incidence and mortality in older men with diabetes and in men with coronary heart disease. Heart 90:1398–1403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Empana JP, Ducimetiere P, Arveiler D (2004) Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? The PRIME study. Eur Heart J 24:1903–1911

    Article  Google Scholar 

  13. Brindle P, Emberson J, Lampe F et al (2003) Predictive accuracy of the Framingham coronary risk score in British men: prospective cohort study. Br Med J 327:1267–1273

    Article  Google Scholar 

  14. Conroy RM, Pyörälä K, Fitzgerald AP et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003

    Article  CAS  PubMed  Google Scholar 

  15. Lampe FC, Whincup PH, Wannamethee SG et al (2001) The natural history of prevalent ischaemic heart disease in middle-aged men. Eur Heart J 21:1052–1062

    Article  Google Scholar 

  16. Clayton TC, Lubsen J, Pocock SJ et al (2005) Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina, based on a large randomised trial cohort of patients. Br Med J 331:869–874

    Article  Google Scholar 

  17. Hemingway H, McCallum A, Shipley M et al (2006) Incidence and prognostic implications of stable angina pectoris among women and men. JAMA 295:1404–1411

    Article  CAS  PubMed  Google Scholar 

  18. Hippisley-Cox J, Coupland C, Vinogradova Y et al (2007) Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. Br Med J 335:136

    Article  Google Scholar 

  19. D’Agostino RB, Vasan RS, Pencina MJ et al (2008) General cardiovascular risk profile for use in primary care. Circulation 117:743–753

    Article  PubMed  Google Scholar 

  20. Steg PG, Bhatt DL, Wilson PWF et al (2007) One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 297:1197–1206

    Article  CAS  PubMed  Google Scholar 

  21. Perna L, Wahl H-W, Mons U, Saum K-U, Holleczek B (2015) Cognitive impairment, all-cause and cause-specific mortality among non-demented older adults. Age Ageing 44:445–451

    Article  PubMed  Google Scholar 

  22. Sachs GA, Carter R, Holtz LR et al (2011) Cognitive impairment: an independent predictor of excess mortality. A cohort study. Ann Intern Med 155:300–308

    Article  PubMed  Google Scholar 

  23. Coresh J, Turin TC, Matsushita K, et al. for the CKD Prognosis Consortium (2014) Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. J Am Med Assoc 311:2518–2531

    Google Scholar 

  24. Myers J, Prakash M, Froelicher V (2002) Exercise capacity and mortality among men referred for exercise testing. New Engl J Med 346:793–801

    Article  PubMed  Google Scholar 

  25. Gulati M, Black HR, Shaw LJ et al (2005) The prognostic value of a nomogram for exercise capacity in women. New Engl J Med 353:468–475

    Article  CAS  PubMed  Google Scholar 

  26. Carlisle JB (2014) Pre-operative co-morbidity and postoperative survival in the elderly: beyond one lunar orbit. Anaesthesia 69(Suppl 1):17–25

    Article  PubMed  Google Scholar 

  27. Thompson SG, Ashton HA, Gao L et al (2012) Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening. Br J Surg 99:1649–1656

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Lederle FA, Wilson SE, Johnson GR et al (2002) Immediate repair compared with surveillance of small abdominal aortic aneurysms. New Engl J Med 346:1437–1444

    Article  PubMed  Google Scholar 

  29. Thompson SG, Brown LC, Sweeting MJ et al (2013) Systematic review and meta-analysis of the growth and rupture rates of small abdominal aortic aneurysms: implications for surveillance intervals and their cost-effectiveness. Health Tech Assess 17:1–118

    Article  CAS  Google Scholar 

  30. Grant SW, Sperrin M, Carlson E et al (2015) Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid and economic evaluation. Health Technol Assess 19:1–154

    Article  PubMed  Google Scholar 

  31. Carlisle JB (2015) Simulations of the effects of scheduled abdominal aortic aneurysm repair on survival. Anaesthesia 70:666–678

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. South Devon and Torbay NHS Foundation Trust, Lowes Bridge, Torquay, Devon TQ2 7AA, UK

    J. Carlisle

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  1. J. Carlisle
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Correspondence to J. Carlisle .

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Editors and Affiliations

  1. Waimairi Anaesthesia Ltd, Christchurch, New Zealand

    Karen Stuart-Smith

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Carlisle, J. (2016). Impact of Co-morbidites, Physiological Status and Age on Survival. In: Stuart-Smith, K. (eds) Perioperative Medicine – Current Controversies. Springer, Cham. https://doi.org/10.1007/978-3-319-28821-5_3

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  • DOI: https://doi.org/10.1007/978-3-319-28821-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28819-2

  • Online ISBN: 978-3-319-28821-5

  • eBook Packages: MedicineMedicine (R0)

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