改良衰弱指数在预测老年腹腔镜结直肠癌手术患者术后并发症中的应用

Modified frailty index predicts postoperative complications in aged patients after laparoscopic colorectal cancer surgery

目的评估改良衰弱指数(mFI)在预测老年腹腔镜结直肠癌手术患者术后并发症中的应用。方法收集广州市第一人民医院2010年1月至2017年12月行腹腔镜结直肠癌手术的老年患者415例,依据患者术前mFI评分分为无衰弱组(mFI≤0.27,373例)、衰弱组(mFI> 0.27,42例),并对两组患者人口统计学、手术相关数据和术后并发症等指标进行统计分析。结果 10.1%的患者被评估为衰弱。衰弱组患者在住院天数、术后并发症及术后30 d死亡率上均与非衰弱组患者存在统计学差异。对术后并发症的多因素分析显示mFI是影响术后并发症的独立危险因素。结论 mFI过高是预测老年结直肠癌患者术后并发症发生的重要指标,术前对老年结直肠癌患者患者进行mFI评分有助于为临床诊疗提供合理依据,降低术后并发症发生率。

Objective To evaluate the application of modified frailty index(mFI)in predicting postoperative complications in aged patients after laparoscopic colorectal cancer surgery. Methods 415 aged patients who underwent laparoscopic colorectal cancer surgery in Guangzhou First People′s Hospital from January 2010 to December 2017 were divided into two groups according to their preoperative mFI scores:the non-frail group(mFI≤0.27,373 cases)and the frail group(mFI > 0.27,42 cases). The two groups were compared in demography,surgical data and postoperative complications. Results 10.1% of the patients were evaluated for frail. There were significant differences in length of stay,postoperative complications and 30-day mortality between the frail group and the non-frail group. Multivariate analysis of postoperative complications showed that mFI was an independent risk factor for postoperative complications. Conclusions High mFI is an important predictor of postoperative complications in aged patients with colorectal cancer. Preoperative mFI score in aged patients with colorectal cancer can provide a reasonable basis for clinical diagnosis and treatment and reduce the incidence of postoperative complications.