Preoperative risk analysis index for frailty predicts short-term outcomes after hepatopancreatobiliary surgery

Abstract Background The Risk Analysis Index (RAI) for frailty is a rapid survey for comorbidities and performance status, which predicts mortality after general surgery. We aimed to validate the RAI in predicting outcomes after hepatopancreatobiliary surgery. Methods Associations of RAI, determined in 162 patients prior to undergoing hepatopancreatobiliary surgery, with prospectively collected 30-day post-operative outcomes were analyzed with multivariate logistic and linear regression. Results Patients (age 62 ± 14, 51% female) had a median RAI of 7, range 0–25. With every unit increase in RAI, length of stay increased by 5% (95% CI: 2–7%), odds of ICU admission increased by 10% (0–20%), ICU length of stay increased by 21% (9–34%), and odds of discharge to a nursing facility increased by 8% (0–17%) (all P  Conclusion While RAI and ACS-NSQIP Risk Calculator comparatively predicted short-term outcomes after HPB surgery, RAI has been specifically designed to identify frail patients who can potentially benefit from preoperative prehabilitation interventions.