The following is a summary of “Predictive Value of a Novel Digital Risk Calculator to determine early patient outcomes after major surgery: A Proof-of-concept pilot study,” published in the April 2024 issue of Surgery by Sliwinski et al.

The Protego Maxima trial aimed to evaluate the efficacy of a novel digital risk assessment tool in predicting short-term surgical outcomes following major surgeries. This prospective cohort analysis focused on patients undergoing major surgical procedures and utilized The Prehab App, software integrating evidence-based risk assessment tools for structured evaluation.

When integrated into clinical workflow, the study hypothesized that this digitized risk assessment could effectively predict postoperative complications and overall survival. In total, 267 patients were included in the analysis, with key inclusion criteria being major surgery and absence of acute pulmo-cardiovascular decompensation. 

Results indicated that patients with higher Risk Assessment Index (RAI) scores and/or longer timed up-and-go (TUG) times had an increased mortality risk at 90 days post-surgery. Receiver Operator Characteristics analysis demonstrated robust predictive capacity, with significant differences observed between high and low-risk groups for 90-day survival and major complications. These findings underscore the potential of The Prehab App in preoperatively estimating mortality and complication risks, offering valuable insights for surgical decision-making. 

However, further validation with larger datasets and potential integration of artificial intelligence methods are warranted to enhance the tool’s generalizability and predictive accuracy across diverse patient populations and surgical subgroups. This proof-of-concept trial sets a promising foundation for future research endeavors to refine perioperative risk assessment and optimize patient outcomes in major surgery settings.

Source: pssjournal.biomedcentral.com/articles/10.1186/s13037-024-00395-y