改良虚弱指数评分越高与翻修全肩关节置换术后 30 天并发症越相关

B. T. Seibold, Theodore Quan, Amy Y. Zhao, Philip M. Parel, Jacob D. Mikula, Frederick Mun, U. Srikumaran, Zachary R. Zimmer
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摘要

以往的研究表明,5项改良虚弱指数(mFI-5)评分的增加与手术效果不佳有关。本研究旨在确定构成 mFI-5 的合并症是否与翻修全肩关节置换术(TSA)后的不良预后相关。利用国家外科质量改进计划数据库,计算了2013年至2019年期间接受翻修全肩关节置换术的所有50岁及以上患者的mFI-5得分。利用皮尔逊卡方检验和多变量回归分析评估了 mFI 评分与各种术后并发症的关联。与 mFI-5 分值为 2+ 的患者相比,mFI-5 分值为 2+ 的患者再入院(OR 2.58)、出血需要输血(OR 3.66)、住院时间延长(OR 2.43)和出院到非家庭目的地(OR 3.与 mFI-5 得分为 0 的患者相比,mFI-5 得分为 1 的患者术后输血(OR 值为 2.46)、住院时间延长(OR 值为 2.16)和出院到非住院地点(OR 值为 2.84)的风险增加。)mFI-5 是一种有价值的工具,可以根据翻修 TSA 术后并发症的风险对患者进行分层。
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Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty
Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA). Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications. Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84). The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
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