SPPB术前衰弱评估在预测老年消化道恶性肿瘤术后并发症发生中的作用

Significance of preoperative frailty assessment based on The Short Physical Performance Battery(SP⁃PB)in predicting postoperative complications of digestive tract malignant tumors in the elderly

目的应用SPPB量表评估术前衰弱,判断其对老年消化道恶性肿瘤患者术后并发症的预测作用。方法选取包头市中心医院普外科收治的82例老年消化道恶性肿瘤患者为研究对象。根据简易体能状况量表(SPPB)分为衰弱患者和非衰弱患者。收集患者临床资料,术后使用外科并发症分级系统评估术后并发症。采用Spearman秩相关分析术前衰弱与术后并发症的相关性,采用logistic回归分析影响老年消化道恶性肿瘤患者术后并发症的危险因素,构建受试者工作特征(ROC)曲线评价术前衰弱对术后并发症的预测价值。结果衰弱患者并发症发生率为77.1%,高于非衰弱患者的20.6%。Spearman秩相关分析结果显示,术前衰弱与术后并发症呈正相关(r=0.558,P<0.001)。logistic多因素回归分析显示,术前衰弱(OR=8.502,95%CI:2.202~32.820,P=0.002)是老年消化道恶性肿瘤患者术后并发症的危险因素。ROC曲线结果表明,术前衰弱预测老年消化道恶性肿瘤患者术后发生并发症的曲线下面积为0.774(95%CI:0.564~0.798)。结论术前衰弱是老年消化道恶性肿瘤患者术后发生并发症的独立危险因素,术前应用SPPB进行衰弱评估有助于降低患者的并发症发生率。

Objective The Short Physical Performance Battery(SPPB)scale was used to evaluate the preoperative frailty and its predictive effect on postoperative complications in elderly patients with digestive tract malignant tumors.Methods A total of 82 elderly patients with digestive tract malignant tumors treated in the Department of General surgery of Baotou Central Hospital were selected as the object of study.According to the SPPB scale,the patients were divided in⁃to frailty and non-frailty patients.The clinical data of patients were collected and the postoperative complications were eval⁃uated by the Clavien-Dindo classification system.Spearman rank correlation analysis was used to analyze the correlation between preoperative frailty and postoperative complications.Logistic regression was used to analyze the risk factors of postoperative complications in elderly patients with digestive tract malignant tumors.The Receiver Operating Characteris⁃tic(ROC)curve was constructed to evaluate the predictive value of preoperative frailty on postoperative complications.Re⁃sults The incidence of complications in frailty patients was 77.1%,which was higher than 20.6%in non-frailty pa⁃tients.The results of Spearman rank correlation analysis showed that preoperative frailty was positively correlated with post⁃operative complications(r=0.558,P<0.001).Logistic multivariate regression analysis showed that preoperative frailty(OR=8.502,95%CI:2.202-32.820,P=0.002)was a risk factor for postoperative complications in elderly patients with digestive tract malignant tumors.The results of ROC curve showed that the area under the curve for predicting postopera⁃tive complications in elderly patients with digestive tract malignant tumor was 0.774(95%CI:0.564-0.798).Conclu⁃sions Preoperative frailty is an independent risk factor for postoperative complications in elderly patients with digestive tract malignant tumor.Preoperative assessment of frailty with SPPB is helpful to reduce the incidence of complications in patients.