A Nomogram for Prediction of Survival for Patients Undergoing Elective Major Noncardiac Surgery

1University of Miami, Miami, FL
2University of Miami, Miami, FL
3Cleveland Clinic, Cleveland, OH
4Cleveland Clinic, Cleveland, OH
5Cleveland Clinic, Cleveland, OH
6Cleveland Clinic, Cleveland, OH
7Cleveland Clinic, Cleveland, OH
8Cleveland Clinic, Cleveland, OH

Meeting: Hospital Medicine 2009, May 14-17, Chicago, Ill.

Abstract number: 106


An accurate prediction model for perioperative outcomes of patients who have been clinically optimized prior to elective noncardiac surgery has not been well studied. We sought to develop a nomogram that would help physician and patient to accurately estimate the likelihood of postoperative survival.


We studied consecutive patients who were systematically evaluated and treated by hospitalists in a preoperative clinic between 2003 and 2006. Thirty‐four routinely available preoperative baseline clinical variables were analyzed to design the predictive modal. The invasiveness of surgery was defined on the basis of the Cleveland Clinic Surgery Bleeding Risk Categories 1–4. Category 1 surgery is minimal‐risk procedure and was excluded from the study.


There were 11,255 eligible patients for analysis (mean age 69 ± 12 years) who were followed for a median of 1.9 years postoperatively. The nomogram (Figure 1) was formulated based on a Cox proportional hazards regression model. The model had a bootstrap‐corrected concordance index of 0.739 and good calibration.

Figure 1. Instructions for physician.


A nomogram was constructed based on preoperative variables that can predict 30‐day, 1‐year, and 3‐year survival probability in patients undergoing elective major noncardiac surgery. This nomogram should be helpful for patient counseling and future trial design.

Author Disclosure:

Y. Olivia Xu‐Cai, none; A. Jaffer, Astra Zeneca, grants; Spaqi and AF Forum, board member; F. Michota, sanofi‐aventis, Genentech, consultant, speakers bureau; C. Whinney, none; M. Kattan, none; D. Gugliotti, none; S. Suri, none; B. Harte, none; F, Michota, SCIOS, Osaka, consultant; A. Jaffer, sanofi‐aventis, Boehringer Ingelheim, consultant.

To cite this abstract:

Xu‐Cai Y, Jaffer A, Michota F, Whinney C, Gugtiotti D, Suri S, Harte B, Kattan M. A Nomogram for Prediction of Survival for Patients Undergoing Elective Major Noncardiac Surgery. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 106. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/a-nomogram-for-prediction-of-survival-for-patients-undergoing-elective-major-noncardiac-surgery/. Accessed May 26, 2019.

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