Department of Anesthesiology, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Wuxi, 214125, People's Republic of China.
Intensive Care Unit, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China.
Aging Clin Exp Res. 2022 Apr;34(4):819-826. doi: 10.1007/s40520-021-01988-8. Epub 2021 Oct 14.
Although frailty as a common geriatric syndrome is associated with postoperative complications, its relationship with postoperative pulmonary complications (PPCs) following pulmonary resections in elderly patients is unclear.
To investigate the relationship between frailty and PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections and explore the effect of the addition of frailty assessment to PPC risk index and ASA on their predictive ability.
In a prospective cohort study, we measured frailty status using the FRAIL scale in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Multivariate analysis was used to identify the relationship between frailty and PPCs. Receiver operating characteristic curves were used to examine the predictive power of frailty and other assessment tools.
227 patients were analyzed in the study. The prevalence of PPCs was 24.7%. Significant differences between patients with and without PPCs were observed in the following aspects: BMI, smoking, COPD, respiratory infection within the last month, FEV1/FVC ratio, creatinine, ASA, frailty and PPC risk index (p < 0.05, respectively). After adjusting for all covariates, frailty was significantly related to PPCs in elderly patients (odds ratio: 6.33, 95% confidence interval: 2.45-16.37). Combined with frailty assessment, the area under the curve for ASA class and PPC risk index was increased to 0.759 (95% CI 0.687-0.831) and 0.821 (95% CI 0.758-0.883).
Frailty was associated with PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Combined with the frailty assessment, the predictive power of the PPC risk index and ASA class was improved.
衰弱是一种常见的老年综合病症，与术后并发症相关，但它与老年患者行电视辅助胸腔镜肺切除术后发生的术后肺部并发症（PPC）之间的关系尚不清楚。
研究衰弱与老年患者行电视辅助胸腔镜肺切除术后发生 PPC 之间的关系，并探讨在 PPC 风险指数和美国麻醉医师协会（ASA）分级的基础上增加衰弱评估对其预测能力的影响。
在一项前瞻性队列研究中，我们使用 FRAIL 量表测量了行电视辅助胸腔镜肺切除术的老年患者的衰弱状态。采用多变量分析来确定衰弱与 PPC 之间的关系。使用受试者工作特征曲线来检查衰弱和其他评估工具的预测能力。
该研究共分析了 227 例患者。PPC 的发生率为 24.7%。有和无 PPC 的患者在以下方面存在显著差异：体重指数、吸烟、慢性阻塞性肺疾病、近 1 个月内的呼吸道感染、FEV1/FVC 比值、肌酐、ASA、衰弱和 PPC 风险指数（p<0.05）。在调整了所有协变量后，衰弱与老年患者的 PPC 显著相关（优势比：6.33，95%置信区间：2.45-16.37）。结合衰弱评估，ASA 分级和 PPC 风险指数的曲线下面积分别增加至 0.759（95%CI 0.687-0.831）和 0.821（95%CI 0.758-0.883）。
衰弱与老年患者行电视辅助胸腔镜肺切除术后发生 PPC 相关。结合衰弱评估，可提高 PPC 风险指数和 ASA 分级的预测能力。
