Key result
The age-adjusted Charlson Comorbidity Index (ACCI) significantly predicted the need for postoperative intensive care unit admission in older patients undergoing hip surgery (AUC 0.582, P=0.003), whereas SORT and ASA scores did not.
Why the study?
The study aimed to evaluate the effectiveness of ASA, SORT, and ACCI scores in determining the need for postoperative ICU admission in patients aged 65 years and older undergoing hip surgery.
Do ACCI, SORT, and ASA scores predict the need for postoperative ICU admission in patients aged 65 years and older undergoing hip surgery?
Case-Control (n=450)
No
Do ACCI, SORT, and ASA scores predict the need for postoperative ICU admission in patients aged 65 years and older undergoing hip surgery?
The age-adjusted Charlson Comorbidity Index (ACCI) can help predict the need for postoperative ICU admission in elderly patients undergoing hip surgery, outperforming SORT and ASA scores.
Answers are grounded in this paper and cite their sources.
ACCI may modestly aid ICU risk stratification in elderly hip surgery; hypothesis-generating and requires prospective validation before practice change.
Objective: We aimed to investigate the effectiveness of the American Society of Anesthesiologists (ASA), the Surgical Outcome Risk Tool (SORT), and age-adjusted Charlson Comorbidity Index (ACCI) scores in determining the requirement for intensive care unit (ICU) admissions in patients aged 65 years and older who underwent hip surgery. Methods: The study population consisted of 450 patients who underwent orthopedic hip surgery. The patients who were admitted to the ICU were either monitored in the postoperative ICU (Group 1) or transferred to the ward (Group 2). SORT and ACCI scores of all patients were recorded. Results: The patients of Group 1 were significantly older than those in Group 2. SORT scores of both groups were comparable. The diagnostic sensitivity and specificity of ACCI scores were determined as 42.1% and 70.8%, respectively. Conclusion: As a conclusion, ACCI scores can predict the need for ICU admissions in patients undergoing hip surgery. Besides, the traditionally used ASA scores are generally higher in this patient group. Determinative criteria for predicting the need for ICU admissions include older age of the patients, presence of comorbidities as hypertension and diabetes mellitus, as well as a long preoperative waiting period.
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Gezer et al. (2025) conducted a case-control in Orthopedic hip surgery (n=450). Age-adjusted Charlson Comorbidity Index (ACCI), SORT, and ASA scores was evaluated on Prediction of ICU admission (AUC for ACCI) (AUC 0.582, 95% CI 0.535-0.628, p=0.003). The age-adjusted Charlson Comorbidity Index (ACCI) significantly predicted the need for postoperative intensive care unit admission in older patients undergoing hip surgery (AUC 0.582, P=0.003), whereas SORT and ASA scores did not.
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