Association Between Preoperative Health and Functional Status and Postoperative Complications in Elderly Patients

Association Between Preoperative Health and Functional Status and Postoperative Complications in Elderly Patients: An Analysis of a Prospective Cohort

Using prospectively collected clinical data from the Chinese Perioperative Database of Elderly Patients, this study retrospectively analyzed patients aged ≥65 years who underwent elective non-cardiac, non-neurosurgical procedures under general anesthesia between April 2020 and April 2022. The study examined the associations between various preoperative health and functional status assessment tools and the occurrence of cardiovascular and cerebrovascular complications within 30 days after surgery, aiming to compare the clinical value of different assessment instruments.

Study Overview

• Status: Completed
• Conditions: Postoperative Complications; Functional Status; Older Adults (65 Years and Older)

• Study Type: Observational
• Enrollment (Actual): 8751

Contacts and Locations

Study Locations

• China
  • Beijing Municipality
    • Beijing, Beijing Municipality, China, 100853
      • Chinese PLA General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients were interviewed one day before surgery and completed a comprehensive preoperative functional status and quality of life assessment, which included the Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), EuroQol Five-Dimension Five-Level (EQ-5D-5L), Metabolic Equivalent of Task (MET), and FRAIL scale.

Description

Inclusion criteria:

1. Aged ≥65 years;
2. Scheduled for elective non-cardiac, non-neurosurgical procedures;
3. Consented to undergo preoperative functional status and quality of life assessments.

Exclusion criteria:

1. Had severe dementia, language disorders, significant hearing or visual impairments, or were in a coma;
2. Had Mini-Mental State Examination (MMSE) scores below the established educational thresholds: <18 for illiterate individuals, <21 for those with primary education (≤6 years), and <25 for those with secondary education or higher (>6 years);
3. Underwent local anesthesia or monitored anesthesia care;
4. Had an operative time ≤30 minutes;
5. Incompleted all the designated functional status and quality of life assessments.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
A retrospective cohort study based on prospectively collected data.; Patients were divided into the MACCE group and the non-MACCE group according to the occurrence of major adverse cardiac and cerebrovascular events within 30 days after surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The primary outcome was the occurrence of MACCE within 30 days after surgery.	The primary outcome was the occurrence of MACCE within 30 days after surgery, defined as any of the following: stroke, myocardial infarction, angina pectoris, congestive heart failure, cardiac arrest, or all-cause mortality.[33] Postoperative complications were systematically assessed on days 1-5, 7, and 30, and continued until discharge. For discharged patients, outcomes were recorded via telephone follow-up, with diagnoses from the treating hospital. For MACCE, postoperative medical records of hospitalized patients were thoroughly reviewed according to the follow-up schedule, including serial measurements of serum myocardial injury biomarkers, electrocardiograms, echocardiograms, coronary angiography findings, postoperative progress notes, consultation records, and expert diagnostic evaluations.	Within 30 days after surgery.

Collaborators and Investigators

• Sponsor: Chinese PLA General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2020
• Primary Completion (Actual): April 30, 2022
• Study Completion (Actual): May 31, 2022

Study Registration Dates

• First Submitted: November 21, 2025
• First Submitted That Met QC Criteria: November 21, 2025
• First Posted (Estimated): December 2, 2025

Study Record Updates

• Last Update Posted (Estimated): December 9, 2025
• Last Update Submitted That Met QC Criteria: December 7, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Quality of life; Older adults; Functional status; Major Adverse Cardiac and Cerebrovascular Events
• Additional Relevant MeSH Terms: Pathologic Processes; Pathological Conditions, Signs and Symptoms; Postoperative Complications
• Other Study ID Numbers: PLAGH - SCALE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No