术前改良衰弱指数与老年胃癌患者术后并发症发生风险的相关性

Correlation of preoperative modified frailty index with the occurrence risk ofpostoperative complications in elderly patients with gastric cancer

目的 探讨术前改良衰弱指数(mFI)与老年胃癌患者术后并发症发生风险的相关性。方法 回顾性分析250例择期行胃癌根治手术的老年胃癌患者临床资料,术前采用mFI评估患者衰弱状态。根据术后30 d内是否发生并发症将其分为发生组(n=45)和未发生组(n=205)。比较两组患者临床资料,并采用多因素Logistic回归模型分析老年胃癌患者术后30 d内发生并发症的影响因素。结果 与未发生组比较,发生组患者的术中出血量增多,术前衰弱(mFI≥3分)比例升高(P<0.05)。多因素Logistic回归分析结果显示,手术时间长、术前衰弱(mFI≥3分)是老年胃癌患者术后30 d内发生并发症的独立危险因素(P<0.05)。结论 术前mFI≥3分的老年胃癌患者术后30 d内发生并发症的风险相对增加。术前可根据mFI评估结果制订个性化的治疗和护理方案,积极进行衰弱管理,或可逆转老年胃癌患者的衰弱状态,从而降低术后并发症发生率,改善患者术后结局。

Objective To explore the correlation of modified frailty index(mFI)with the occurrence risk of postoperative complications in elderly patients with gastric cancer.Methods The clinical data of 250 elderly patients with gastric cancer who underwent selective radical surgery for gastric cancer were retrospectively analyzed,and preoperative mFI was used to evaluate patients frailty states.Patients were assigned to occurrence group(n=45)or nonoccurrence group(n=205)according to whether complications within 30 days after surgery occurred or not.The clinical data were compared between patients of the two groups,and the influencing factors for the occurrence of complications within 30 days after surgery in elderly patients with gastric cancer were analyzed by using the multivariate Logistic regression model.Results Compared with the nonoccurrence group,the occurrence group exhibited increased intraoperative bleeding volume,elevated preoperative frailty proportion(mFI≥3 points,P<0.05).The results of multivariate Logistic regression analysis revealed that long operation duration,preoperative frailty(mFI≥3 points)were the independent risk factors for the occurrence of complications within 30 days after surgery in elderly patients with gastric cancer(P<0.05).Conclusion Elderly gastric cancer patients with preoperative mFI≥3 points have increased risk of the occurrence of complications within 30 days after surgery.According to the results of mFI evaluation,individualized treatment and nursing regimens can be formulated before surgery,and active frailty management can reverse frailty states of elderly patients with gastric cancer,thereby decreasing the incidence rate of postoperative complications,and improving outcomes of patients after surgery.