Modified Frailty Index for Patients Undergoing Surgery for Colorectal Cancer: Analysis of the National Inpatient Sample From 2015 to 2019.

IF 1 4区医学 Q3 SURGERY American Surgeon Pub Date : 2025-01-01 Epub Date: 2024-08-06 DOI:10.1177/00031348241269398

Rehab Alsayari, Tyler McKechnie, Tania Kazi, Luke Heimann, Anjali Sachdeva, Yung Lee, Bright Huo, Niv Sne, Dennis Hong, Cagla Eskicioglu

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Abstract

Background: Frailty is increasingly recognized as a perioperative risk for numerous surgical diseases. We applied the modified frailty index (mFI-11) to the National Inpatient Sample (NIS) for patients undergoing surgery for colorectal cancer (CRC).

Methods: We performed a retrospective analysis of the NIS (2015-2019) including CRC patients undergoing surgery. We classified patients into frail (ie, mFI ≥0.27) and robust (ie, mFI <0.27) categories. Primary outcomes were in-hospital postoperative morbidity and mortality. The secondary outcomes included system-specific postoperative morbidity and length of stay (LOS). Multivariable regression models were fit.

Results: Within the 53,652 identified patients undergoing surgery for CRC, 19.1% were frail. Frail patients were at higher risk of postoperative mortality (3.1% vs 1.0%, odds ratio [OR] 1.96, 95% confidence intervals [CIs] 1.68-2.30, P < 0.001), morbidity (41.3 % vs 23.1%, OR 1.75, 95% CI 1.66-1.83, P < 0.001), and LOS (mean difference [MD] 1.46, 95% CI 0.29-1.62, P < 0.001). Significant differences existed between groups in system-specific postoperative morbidity, with the largest effect estimates seen in cardiovascular morbidities (OR 4.07, 95% CI 3.36-4.93, P = 0.001), followed by respiratory (OR 1.75, 95% CI 1.66-1.83, P = 0.001).

Conclusion: Frail patients undergoing CRC surgery are at risk of increased postoperative complications. Preoperative frailty screening may allow for individualized preoperative counseling.

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2015 - 2019年全国结直肠癌手术患者修正衰弱指数分析

背景：虚弱越来越被认为是许多外科疾病的围手术期风险。我们将修正的衰弱指数（mFI-11）应用于接受结直肠癌（CRC）手术的国家住院患者样本（NIS）。方法：我们对NIS（2015-2019）进行回顾性分析，包括接受手术的结直肠癌患者。我们将患者分为虚弱（即mFI≥0.27）和强壮（即mFI）。结果：在53,652例接受结直肠癌手术的患者中，19.1%虚弱。体弱患者术后死亡率（3.1% vs 1.0%，优势比[OR] 1.96, 95%可信区间[CI] 1.68 ~ 2.30, P < 0.001）、发病率（41.3% vs 23.1%, OR 1.75, 95% CI 1.66 ~ 1.83, P < 0.001）和LOS（平均差[MD] 1.46, 95% CI 0.29 ~ 1.62, P < 0.001）的风险较高。两组间系统特异性术后发病率存在显著差异，心血管发病率的影响最大（OR 4.07, 95% CI 3.36-4.93, P = 0.001），其次是呼吸系统发病率（OR 1.75, 95% CI 1.66-1.83, P = 0.001）。结论：接受结直肠癌手术的体弱患者术后并发症风险增加。术前虚弱筛查可以提供个体化的术前咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Surgeon 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

623

期刊介绍： The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.