Sinai Abbreviated Geriatric Evaluation: Development and Validation of a Practical Test

Area of Science:

• Geriatric Medicine
• Surgical Outcomes Research
• Health Services Research

Background:

• Many existing tools for predicting treatment risk in older adults are too complex for routine clinical use.
• There is a need for a simple, validated geriatric screening tool for preoperative assessment.

Purpose of the Study:

• To develop and validate a simple geriatric screening tool, the Sinai Abbreviated Geriatric Evaluation (SAGE).
• To compare the performance of the SAGE with existing complex geriatric assessments in predicting postoperative outcomes.

Main Methods:

• Prospective comprehensive preoperative evaluations of 1025 patients aged ≥75 undergoing major elective surgery.
• Retrospective review of postoperative outcomes and analysis using logistic regression and receiver operating characteristic (ROC) curve analysis.
• Development of the SAGE tool by selecting the best combination of simple tests.

Main Results:

• The SAGE score was a significant predictor of postoperative complications, delirium, length of hospital stay, readmission, and discharge disposition.
• The area under the ROC curve (AUC) for the SAGE ranged from 0.66 to 0.78 for various outcomes.
• The SAGE demonstrated performance comparable to Fried's frailty phenotype, Charlson Comorbidity Index, and ASA classification.

Conclusions:

• The Sinai Abbreviated Geriatric Evaluation (SAGE) is a statistically significant predictor of adverse postoperative outcomes.
• The SAGE performs as well as more complex geriatric evaluations that require specialized equipment or memorization.
• The SAGE offers a practical and effective tool for geriatric risk assessment in surgical patients.