BackgroundAnesthesia crisis management (ACM) simulation would expose anesthesiology residents and trainees to dynamic emergencies that need quick yet effective responses to gain their core strength and capabilities as anesthesiologists. Our department had already employed ACM simulation into modules and practiced in examinations. The aim is to enhance professional working ethics and human responsibility in residents, which would be accomplished in semi-realistic simulation. This would be a useful tool for lecturers to evaluate current teaching methods and measure protégés in daily emergencies, which should be done better in continuous pattern.MethodsWe analyzed the ACM simulation scores from resident examination using Strata SE programs. The examination consisted of four topics in which points counted for each topic ranged from 0 to 15 and then would be counted into percentage for passing grade. The required minimum passing grade for each topic was 75%, in which the average score for one topic was 11.25.DiscussionOverall average score for all subjects was 12.07, which already achieved the 75% passing grade with a cutoff point of 11.25. Postsurgical bleeding and cannot intubate–cannot oxygenate topics were the two bottom topics that could not achieve the 75% passing grade. Preoperative evaluation and decision making were two lowest non-technical skill scores in the examination.ConclusionWeakest core competencies were found in preoperative evaluation and decision making even though all subjects had already passed the minimum requirements of 75% passing grade. Postsurgical bleeding and cannot intubate–cannot oxygenate were also topics with lowest scores in core competencies. These findings would suggest for innovation and reevaluation of current teaching.
Background
Aging is an irreversible, progressive and cumulative process that involves biological, anatomical, physiological, and functional changes that occur over a period of time. Emergency surgery in geriatrics is challenging due to the limited time for surgery planning. Charlson Age Comorbidity Index (CACI) can be used as a predictor of mortality in geriatric patients undergoing surgery. The study’s aim is to determine the association between CACI and mortality in geriatric patients undergoing emergency surgery.
Methods
This study was a prospective analytic observational multicenter study. This study was conducted from February 2021 to April 2021. This study used the whole sampling method and was followed up 30 days after surgery. The data were analyzed using regression and the ROC Curve test with a confidence interval of 95%.
Results
We obtained 116 geriatric patients undergoing emergency surgery with a 30-day mortality rate of 11.2%. CACI significantly correlated with 30 day-mortality in geriatric underwent emergency surgery (p = 0.000) with B = 4.831. The AUC of the CACI score was 0.966, with a cut-off value of 5.5. For geriatric patients with CACI scores > 5.5, the risk of mortality within 30 days of treatment is 125.33 times greater (95% CI: 14.58–1077.67) than for patients with CACI scores < 5.5.
Conclusion
CACI is associated with 30-day mortality in geriatric patients undergoing emergency surgery. CACI score also could be used to predict 30-day mortality in geriatric underwent emergency surgery.
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