"Timed Up & Go": A screening tool for predicting 30-day morbidity in onco-geriatric surgical patients? A multicenter cohort study

Objective To determine the predictive value of the \u201cTimed Up & Go\u201d (TUG), a validated assessment tool, on a prospective cohort study and to compare these findings to the ASA classification, an instrument commonly used for quantifying patients\u2019 physical status and anesthetic risk. Background In the onco-geriatric surgical population it is important to identify patients at increased risk of adverse post-operative outcome to minimize the risk of over- and under-treatment and improve outcome in this population. Methods 280 patients 6570 years undergoing elective surgery for solid tumors were prospectively recruited. Primary endpoint was 30-day morbidity. Pre-operatively TUG was administered and ASA-classification was registered. Data were analyzed using multivariable logistic regression analyses to estimate odds ratios (OR) and 95% confidence intervals (95%-CI). Absolute risks and area under the receiver operating characteristic curves (AUC\u2019s) were calculated. Results 180 (64.3%) patients (median age: 76) underwent major surgery. 55 (20.1%) patients experienced major complications. 50.0% of patients with high TUG and 25.6% of patients with ASA 653 experienced major complications (absolute risks). TUG and ASA were independent predictors of the occurrence of major complications (TUG:OR 3.43; 95%-CI\u200a=\u200a1.14\u201310.35. ASA1 vs. 2:OR 5.91; 95%-CI\u200a=\u200a0.93\u201337.77. ASA1 vs. 3&4:OR 12.77; 95%-CI\u200a=\u200a1.84\u201388.74). AUCTUG was 0.64 (95%-CI\u200a=\u200a0.55\u20130.73, p\u200a=\u200a0.001) and AUCASA was 0.59 (95%-CI\u200a=\u200a0.51\u20130.67, p\u200a=\u200a0.04). Conclusions Twice as many onco-geriatric patients at risk of post-operative complications, who might benefit from pre-operative interventions, are identified using TUG than when using ASA