Imaoka Yukihiro, Kawano Takayuki, Hashiguchi Akihito, Fujimoto Kenji, Yamamoto Keizou, Nishi Toru, Otsuka Tadahiro, Yano Shigetoshi, Mukasa Akitake
Department of Neurosurgery, Hitoyoshi Medical Center, 35 Oigamicho, Hitoyoshi city, Kumamoto, 868-8555, Japan; Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto city, Kumamoto, 860-8556, Japan.
Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto city, Kumamoto, 860-8556, Japan.
Clin Neurol Neurosurg. 2018 Dec;175:137-143. doi: 10.1016/j.clineuro.2018.11.004. Epub 2018 Nov 5.
Frailty is an indispensable concept among elderly. The purpose of this study was to determine the association between modified frailty index (mFI) and the postoperative outcome of surgery for spontaneous intracerebral hemorrhage (sICH).
Outcome measures included an unfavorable outcome (modified Rankin Scale score of 4-6) or mortality at 6-8 months after hemorrhage. The prognostic ability of mFI was assessed by comparing adjusted and nonadjusted effects with the Hemphill's ICH score. The performance of the ICH score combined with mFI was assessed for discriminative ability.
In total, 156 patients satisfied the inclusion criteria. Multivariate analyses revealed that higher mFI was significantly associated with an unfavorable outcome (p-value = 0.004) and mortality (p-value < 0.001). Compared with the ICH score alone, the ICH score combined with mFI revealed significantly higher discriminative ability for predicting postoperative outcome.
mFI was a useful and reliable predictor of postoperative unfavorable outcome for sICH. Frailty may be an important essence to be considered before operation for sICS in the aging society.
衰弱是老年人中一个不可或缺的概念。本研究的目的是确定改良衰弱指数(mFI)与自发性脑出血(sICH)手术术后结局之间的关联。
结局指标包括出血后6 - 8个月时的不良结局(改良Rankin量表评分为4 - 6分)或死亡。通过将调整后的和未调整的效应与Hemphill脑出血评分进行比较,评估mFI的预后能力。评估脑出血评分与mFI相结合的表现的判别能力。
共有156例患者符合纳入标准。多因素分析显示,较高的mFI与不良结局(p值 = 0.004)和死亡率(p值 < 0.001)显著相关。与单独的脑出血评分相比,脑出血评分与mFI相结合对预测术后结局具有显著更高的判别能力。
mFI是sICH术后不良结局的一个有用且可靠的预测指标。在老龄化社会中,衰弱可能是sICS手术前需要考虑的一个重要因素。