Predicting 1-year mortality in surgical ≥ ASA 3 patients at the preanesthesia consultation clinic
Anesthesia healthcare providers were trained to complete the DSQ during the pre-anesthesia consultation for patients with ASA classification ≥ III undergoing elective non-cardiac surgery (and inclusion of cardiac surgery in Amsterdam). The DSQ was incorporated into the anesthesia questionnaire but was not mandatory, similar to other optional elements of the questionnaire. Consequently, anesthesia providers could finalize the consultation without completing the DSQ. All other steps of the pre-anesthesia consultation were performed as per routine practice. Patients of whom the DSQ is filled presenting at the anesthesia clinic in Amsterdam and Nijmegen during an approximately six-month period in 2024 will be included in the analysis. The following demographic and perioperative data will be collected: age (years), weight (kg), ASA classification (III, IV, V), type of surgery, expected and actual duration of surgery, expected and actual blood loss, expected ICU stay, type of anesthesia (general, procedural sedation and analgesia (PSA), neuraxial, locoregional, general/PSA combined with locoregional or neuraxial anesthesia and length of postoperative hospital stay. The consultation of a palliative care team or availability of an ACP in the electronic patient file at the time of the anesthesia consultation or postoperatively will also be recorded. One year after the PAC, the following data will be collected: • Survival status of all patients ≥ ASA 3 presented for elective non cardiac surgery. • For patients in group 1, 2, 3 and patients who died in group 4 the following outcomes will be retrieved from the medical records: provision of chemotherapy or immunotherapy, ≥2 emergency department visits, ≥1 hospital readmission, hospitalization >14 days, ≥1 unplanned intensive care unit admission, and in-hospital death during one-year follow-up or until death, necessity for an new surgery during the same hospital admission, was a palliative consultation or ACP done. Of the ≥
1. ≥ ASA 3 2. elective non-cardiac surgery in Nijmegen and in Amsterdam cardiac surgery patients 3. DSQ is filled during consultation at the PAC
1. ASA < 2 2. No pre-anesthesia consultation 3. Emergency surgery 4. Cardiac surgery in Nijmegen 5. Explicit statement to use of patient data 6. Protected patient file for privacy reasons