功能而非医学上的虚弱与结直肠癌手术后的长期残疾相关。
Functional Not Medical Frailty Is Associated With Long-Term Disability After Surgery for Colorectal Cancer.
作者信息
Ginesi Meridith, Bingmer Katherine, Bliggenstorfer Johnathan T, Ofshteyn Asya, Steinhagen Emily, Stein Sharon L
机构信息
Department of Surgery, University Hospitals Research in Surgical Outcomes and Effectiveness (UH RISES), Cleveland, USA.
Department of Colorectal Surgery, University Hospitals Cleveland Medical Center, University Hospitals Research in Surgical Outcomes and Effectiveness (UH RISES), Cleveland, USA.
出版信息
Cureus. 2022 Mar 16;14(3):e23216. doi: 10.7759/cureus.23216. eCollection 2022 Mar.
BACKGROUND
Frailty has been associated with increased morbidity after surgery. However, few studies investigate long-term functional outcomes.
METHODS
Patients ≥ 65 years old who underwent surgery for colorectal cancer were surveyed regarding their ability to perform activities of daily living, measured by Barthel Index, before and after surgery. Patients also reported time to return to their functional baseline.
RESULTS
Pre-operative moderate dependency was associated with declining function at six months (OR: 8.8; CI: 1.8-42.6) and one year post-operatively (OR: 17.5; CI: 2.8-109.8). Pre-operative functional frailty was associated with subjective failure to return to baseline (OR: 4.8 and 4.2) for slightly and moderately dependent patients and a longer time to return to baseline. Medical frailty, based on the modified Frailty Index, was not significantly associated with failure to return to baseline.
CONCLUSIONS
Measures of functional frailty are better predictors of failure to return to baseline, than measures of medical frailty.
背景
虚弱与术后发病率增加有关。然而，很少有研究调查长期功能结局。
方法
对接受结直肠癌手术的65岁及以上患者进行调查，了解他们在手术前后通过巴氏指数测量的日常生活活动能力。患者还报告了恢复到功能基线的时间。
结果
术前中度依赖与术后6个月（比值比：8.8；可信区间：1.8 - 42.6）和术后1年（比值比：17.5；可信区间：2.8 - 109.8）的功能下降有关。术前功能虚弱与轻度和中度依赖患者主观上未能恢复到基线（比值比：4.8和4.2）以及恢复到基线的时间较长有关。基于改良虚弱指数的医学虚弱与未能恢复到基线无显著关联。
结论
与医学虚弱指标相比，功能虚弱指标是未能恢复到基线的更好预测指标。
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