改良衰弱指数对预测食管癌切除术后肺炎发生的有效性
Usefulness of the Modified Frailty Index for Predicting Pneumonia Occurrence After Esophagectomy.
作者信息
Miyauchi Wataru, Matsunaga Tomoyuki, Sakano Yu, Makinoya Masahiro, Shimizu Shota, Shishido Yuji, Miyatani Kozo, Sakamoto Teruhisa, Hasegawa Toshimichi, Fujiwara Yoshiyuki
机构信息
Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
出版信息
Yonago Acta Med. 2023 Jan 17;66(1):1-6. doi: 10.33160/yam.2023.02.001. eCollection 2023 Feb.
BACKGROUND
Esophagectomy is an invasive and complication-prone surgical procedure. Therefore, a tool that can predict the occurrence of postoperative complications may be useful for perioperative management. In this study, we investigated whether the modified frailty index (mFI) could be a useful tool for predicting the postoperative complications of esophagectomy.
METHODS
In this study, 162 patients who underwent curative esophagectomy for esophageal squamous cell carcinoma from 2004 to 2019 at our institution were included. The patients were divided into the high mFI (≥ 0.27) and low mFI (< 0.27) groups, and the short-term postoperative outcomes of each group were examined retrospectively.
RESULTS
Regarding background factors, age and the American Society of Anesthesiologists physical status classification were significantly higher in the high mFI group ( = 0.049 and = 0.002, respectively); however, the other items were not significantly different between the two groups. Regarding surgical outcomes, no significant differences in operative time, blood loss, and hospital stay were observed between the two groups. Regarding postoperative complications, pneumonia was significantly more common in the high mFI group ( = 0.035). In multivariate analysis, high mFI ( = 0.034) was an independent predictor of pneumonia, along with operative time ≥ 613 min ( = 0.03) and preoperative BMI < 20.48 ( = 0.006).
CONCLUSION
The mFI is useful for predicting pneumonia after esophagectomy.
背景
食管切除术是一种侵入性手术，且容易出现并发症。因此，一种能够预测术后并发症发生情况的工具可能有助于围手术期管理。在本研究中，我们调查了改良虚弱指数（mFI）是否可作为预测食管切除术后并发症的有用工具。
方法
本研究纳入了2004年至2019年在我院接受食管癌鳞状细胞癌根治性食管切除术的162例患者。将患者分为高mFI（≥0.27）组和低mFI（<0.27）组，并对每组的术后短期结局进行回顾性研究。
结果
关于背景因素，高mFI组的年龄和美国麻醉医师协会身体状况分级显著更高（分别为P = 0.049和P = 0.002）；然而，两组之间的其他项目没有显著差异。关于手术结果，两组之间在手术时间、失血量和住院时间方面没有观察到显著差异。关于术后并发症，高mFI组的肺炎明显更常见（P = 0.035）。在多变量分析中，高mFI（P = 0.034）是肺炎的独立预测因素，同时手术时间≥613分钟（P = 0.03）和术前体重指数<20.48（P = 0.006）也是。
结论
mFI可用于预测食管切除术后的肺炎。
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