Clinical risk assessments
Figure 2 illustrates patient distribution of clinical risk
classification according to assessment method providing a visual of the
(dis) agreements observed complemented by the CHAID decision tree method
analyses summarised in Figures 2-3.
Subjective: There was clear disagreement between the
subjective assessments of risk (ICE-Eyeball (Frailty) compared to Notes
Review (Fitness) with ~34 % of patients classified not
frail considered unfit by notes review (Figure 3 A). Equally,
~88 % of patients considered not frail and
~82 % of patients considered fit by ICE (Figure 3 B)
and notes review (Figure 3 C) respectively were classified ASA Grade
II-III (mild to severe disease).
Objective: Subjective assessments generally
underestimated patient risk compared to objective CPET criteria
(V̇ O2-AT <11 mL/kg/min and
intermediate-to-high risk). Indeed, ~35 % of patients
considered not frail on ICE and ~31 % of patients
considered fit by notes review exhibited a V̇ O2-AT
<11 mL/kg/min (Figure 4 A-B). Of these, ~28 %
and ~19 % (not frail and fit patients respectively)
were classified as intermediate-to-high risk by CPET criteria (Figure 4
C-D).