|
|
Modified Frailty Index in prediction of complications after robot-assisted hepatectomy in elderly patients |
DONG Shasha1, XIN Wenqi2 |
1. Department of Anesthesiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China; 2. Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475004, China |
|
|
Abstract Objective To evaluate the value of modified frailty index (mFI) in the prediction of complications after robot-assisted hepatectomy in elderly patients. Methods The clinical data of 100 elderly patients undergoing robot-assisted hepatectomy at the Sixth Medical Center of PLA General Hospital from January 2021 to January 2024 were retrospectively analyzed, and the patients were divided into the frailty group (mFI≥0.27) and the non-frailty group (mFI < 0.27) according to the mFI value. The general perioperative data of the two groups were compared to explore the relationship between mFI score and postoperative complications and postoperative outcomes in elderly patients after robot-assisted hepatectomy. The accuracy of mFI score in predicting postoperative complications was evaluated by receiver operating characteristics (ROC) curve. Results A total of 90 elderly patients undergoing hepatectomy were included in this study, including 42 patients in the frailty group and 48 patients in the non-frailty group. There were statistical differences in age, ASA grade and total bilirubin between the two groups(P<0.05). The length of hospital stay and the incidence of complications within 30 days after operation in frailty group were higher than those in non-frailty group with statistically significant differences (P<0.05). Multivariate Logistic regression analysis showed that mFI was the independent risk factor for the complications in respiratory system (OR=5.691; 95%CI: 0.842~0.985; P=0.001), nervous system (OR=5.162; 95%CI: 0.836~0.968; P=0.001), and cardiovascular system (OR=7.548; 95%CI: 0.873~0.996; P=0.001). Conclusions mFI has clinical application value in predicting postoperative complications in elderly patients with robot-assisted hepatectomy.
|
Received: 20 October 2024
|
|
|
|
|
[1] |
中华人民共和国国家卫生健康委员会. 原发性肝癌诊疗指南(2024年版)[J].中国临床医学,2024,31(2):277-334.
|
[2] |
Yoshino O,Wang Y, McCarron F, et al. Major hepatectomy in elderly patients: possible benefit from robotic platform utilization[J]. Surg Endosc,2023,37(8):6228-6234.
|
[3] |
曹甜甜, 张 琳, 翟 莉. 某部队医院老年共病患者衰弱发生情况、影响因素及其预后[J]. 武警医学, 2024, 35(11): 971-975.
|
[4] |
牛 望, 刘 馨, 李 涛,等. 老年腹部手术患者术前衰弱状态和手术转归的相关性研究及潜在机制探讨[J]. 国际麻醉学与复苏杂志, 2023, 44(3): 243-250.
|
[5] |
Hildebrand N,Verkoulen K,Dewulf M,et al. Short-term outcomes of laparoscopic versus open hepatectomy in the elderly patient:systematic review and meta-analysis[J].HPB(Oxford),2021,23(7):984-993.
|
[6] |
Bludevich B M, Emmerick I, Uy K, et al. Association between the modified frailty index and outcomes following lobectomy[J]. J Surg Res,2023,283: 559-571.
|
[7] |
Delvecchio A, Conticchio M, Ratti F, et al. Laparoscopic major hepatectomy for hepatocellular carcinoma in elderly patients: a multicentric propensity scorebased analysis[J]. Surg Endosc,2021,35(7):3642-3652.
|
[8] |
叶淑君,杨 铎,张隆盛. 衰弱及改良衰弱指数的研究进展[J].汕头大学医学院学报,2023,36(2):125-128.
|
[9] |
杜滨和,徐 楠,杨云川,等. 5项改良衰弱指数预测胰十二指肠切除术近期预后的价值探讨[J].中华普通外科学文献(电子版),2023,17(6):444-448.
|
[10] |
郝新宇,欧阳春磊,徐子尧,等. 改良衰弱指数预测老年全髋关节置换术后并发症的临床应用[J].中华老年多器官疾病杂志,2022,21(7):481-485.
|
[11] |
Ogata T, Sadakari Y, Nakane H, et al. The five-item modified frailty index predicts long-term outcomes in elderly patients undergoing colorectal cancer surgery[J]. World J Surg Oncol,2023,21(1):268.
|
[12] |
Maeda Y, Eto K, Yoshida N, et al. The 5-factor modified frailty index is a novel predictive marker of death from other diseases after curative gastrectomy for gastric cancer[J]. Geriatr Gerontol Int,2023,23(10):750-756.
|
[13] |
李勇坤,尤 楠,王 峥,等. 改良衰弱指数预测老年腹腔镜肝切除患者术后并发症的价值研究[J].腹部外科,2023,36(1):12-16.
|
[14] |
艾 英,杨亚男,孟丽华,等. 改良衰弱指数预测机器人辅助下老年前列腺癌根治术后并发症的临床应用[J].实用老年医学, 2023, 37(11): 1143-1146.
|
[15] |
刘 荣,胡三元. 腹腔镜肝胆胰手术操作指南[J].临床肝胆病杂志,2019,35(7):1450-1458.
|
[16] |
中华医学会老年医学分会 《中华老年医学杂志》编辑委员会. 老年人衰弱预防中国专家共识 (2022) [J].中华老年医学杂志,2022,41 (5):503-511.
|
[17] |
Ali B, Choi E E, Barlas V, et al. Modified frailty index (mFI) predicts 30-day complications after microsurgical breast reconstruction[J]. J Plast Surg Hand Surg,2022,56(4):229-235.
|
[18] |
Suzuki Y,Tei M,Ohtsuka M,et al. Effectiveness of frailty screening and perioperative team management of colectomy patients aged 80 years or more[J].Am J Surg,2022, 223(2):346-352.
|
[19] |
苏红霞,颜琬华. 老年胃癌患者衰弱和营养风险与术后肺部感染的相关性研究[J].实用临床医药杂志, 2023, 27(9): 71-75.
|
[20] |
Shen Y, Hao Q, Wang Y, et al. The association between preoperative modified frailty index and postoperative complications in Chinese elderly patients with hip fractures[J]. BMC Geriatr,2021,21(1): 370.
|
[21] |
何少帅, 阳丹才让. 肝切除术后肝衰竭的研究进展[J]. 临床医学进展, 2022, 12(10): 9477-9484.
|
[22] |
朱思颖,孙乙灵,林琦琦,等. 老年急症患者衰弱状态与住院时长的相关性分析[J]. 中华保健医学杂志, 2024, 26(2): 151-154.
|
[23] |
Taghlabi K M, Quaddoura A A, Nisar A, et al. Modified 5-item frailty index: a useful tool for assessing the impact of frailty on postoperative morbidity and mortality following surgical fixation of thoracolumbar fractures[J].World Neurosurgery,2024,187: e1062-e1071.
|
[24] |
Li R,Sidawy A, Nguyen B N.The 5-Factor modified frailty index is a succinct yet effective predictor of adverse outcomes in patients undergoing open surgery for abdominal aortic aneurysm[J]. Ann Vasc Surg,2024,104: 139-146.
|
[25] |
Naveen B, Isaiah C, Vishruth T,et al. Frailty index (mFI-5) predicts resource utilization after nonruptured endovascular aneurysm repair[J]. J Surg Res,2023,283: 507-513.
|
[26] |
Edward C, Tjoson T, Yarah M, et al. Association between 5-item modified frailty index and short-term outcomes in complex head and neck surgery[J].Otolaryngol Head Neck Surg,2022,166(3): 482-489.
|
|
|
|