Department of General and Digestive Surgery, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain; Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Department of General and Digestive Surgery, University Hospital of Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain; Department of Medical and Surgical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
J Surg Res. 2019 Dec;244:218-224. doi: 10.1016/j.jss.2019.06.011. Epub 2019 Jul 10.
Frailty has been proposed as an independent risk factor for predicting postsurgical outcomes in elderly surgical patients. The Comprehensive Complication Index (CCI) seems to be the most widely used grading of individual complications in many surgical fields. The objective of this study was to evaluate the association of frailty, measured by Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS), with the CCI in the elderly surgical patient.
A prospective cross-sectional study was carried out in 256 patients aged ≥70 y who underwent major gastrointestinal surgery. Sociodemographic characteristics, baseline disease, CSHA-CFS, and medical/surgical complication using the Comprehensive Comorbidity Index were evaluated. We hypothesized that frailty measured by CSHA-CFS and the CCI are associated.
Of 256 patients, 154 (60%) were men and 102 (40%) were women, with mean age of 76.1 y (SD ± 5.1). One-hundred and eighty-five patients (74%) underwent surgery for a malignant cause, and 97 patients (38%) had some degree of frailty. Mean CCI was 16.1 (SD ± 23.0). Postoperative mortality was 3%. Pondering the scale CCI 0-100, frailty correlated well with postoperative complications (P = 0.035). For patients who developed at least 1 complication, for each unit that the CSHA-CFS was raised, the CCI increased by 5.2 points (P = 0.002). The multivariate analysis showed that the CSHA-CFS was the only independent prognostic factor associated with postoperative CCI in this series.
Frailty determined by CSHA-CFS is closely associated with the CCI, being a good predictor of postoperative complications in the elderly patient operated on by a major gastrointestinal procedure.
衰弱已被提出作为预测老年外科患者术后结局的独立危险因素。综合并发症指数（CCI）似乎是许多外科领域中个体并发症分级最广泛使用的方法。本研究的目的是评估通过加拿大健康老龄化研究-临床衰弱量表（CSHA-CFS）测量的衰弱与老年外科患者 CCI 的相关性。
对 256 名年龄≥70 岁接受重大胃肠手术的患者进行了前瞻性横断面研究。评估了社会人口统计学特征、基线疾病、CSHA-CFS 和使用综合合并症指数的医疗/手术并发症。我们假设 CSHA-CFS 测量的衰弱与 CCI 相关。
在 256 名患者中，154 名（60%）为男性，102 名（40%）为女性，平均年龄为 76.1 岁（标准差±5.1）。185 名患者（74%）因恶性疾病接受手术，97 名患者（38%）有一定程度的衰弱。平均 CCI 为 16.1（标准差±23.0）。术后死亡率为 3%。考虑 CCI 0-100 量表，衰弱与术后并发症相关性良好（P=0.035）。对于至少发生 1 种并发症的患者，CSHA-CFS 每增加 1 个单位，CCI 增加 5.2 分（P=0.002）。多变量分析显示，CSHA-CFS 是该系列中与术后 CCI 相关的唯一独立预后因素。
CSHA-CFS 确定的衰弱与 CCI 密切相关，是接受重大胃肠手术的老年患者术后并发症的良好预测指标。
