Department of Mechanical Engineering, Chung Yuan Christian University, Chung Li District, No. 200, Zhongbei Rd., Zhongli Dist, Taoyuan, 320314, Taiwan (R.O.C.).
Tai-An Hospital, Taichung, 401007, Taiwan.
Urolithiasis. 2024 Jun 19;52(1):95. doi: 10.1007/s00240-024-01595-y.
To evaluate the impact of frailty on perioperative outcomes of older patients undergoing PCNL, utilizing the US Nationwide Inpatient Sample (NIS) database. Data of hospitalized patients ≥ 60 years who received PCNL were extracted from the 2010 to 2020 NIS database, and included demographics, clinical, and hospital-related information. Patients were assigned to low (< 5), medium (5-15), and high frailty risk (> 15) groups based on the hospital frailty risk score (HFRS). Associations between frailty risk and perioperative outcomes including total hospital cost were determined using population-weighted linear and logistic regression analyses. Data of 30,829 hospitalized patients were analyzed (mean age 72.5 years; 55% male; 78% white). Multivariable analyses revealed that compared to low frailty risk, increased frailty risk was significantly associated with elevated in-hospital mortality (adjusted odds ratio (aOR) = 10.70, 95% confidence interval (CI): 6.38-18.62), higher incidence of unfavorable discharge (aOR = 5.09, 95% CI: 4.43-5.86), prolonged hospital length of stay (LOS; aOR = 7.67, 95% CI: 6.38-9.22), increased transfusion risk (aOR = 8.05, 95% CI: 6.55-9.90), increased total hospital costs (adjusted Beta = 37.61, 95% CI: 36.39-38.83), and greater risk of complications (aOR = 8.52, 95% CI: 7.69-9.45). Frailty is a significant prognostic indicator of adverse perioperative outcomes in older patients undergoing PCNL, underscoring importance of recognizing and managing frailty in older patients.
为了评估衰弱对接受 PCNL 的老年患者围手术期结局的影响，我们利用了美国全国住院患者样本（NIS）数据库。从 2010 年至 2020 年 NIS 数据库中提取了 ≥ 60 岁接受 PCNL 的住院患者的数据，其中包括人口统计学、临床和医院相关信息。根据医院衰弱风险评分（HFRS），患者被分为低（< 5）、中（5-15）和高（> 15）衰弱风险组。使用加权线性和逻辑回归分析确定衰弱风险与围手术期结局（包括总住院费用）之间的关联。分析了 30829 名住院患者的数据（平均年龄 72.5 岁；55%为男性；78%为白人）。多变量分析显示，与低衰弱风险相比，衰弱风险增加与住院死亡率升高（校正优势比（aOR）=10.70，95%置信区间（CI）：6.38-18.62）、不良出院率（aOR=5.09，95%CI：4.43-5.86）、住院时间延长（aOR=7.67，95%CI：6.38-9.22）、输血风险增加（aOR=8.05，95%CI：6.55-9.90）、总住院费用增加（校正β=37.61，95%CI：36.39-38.83）和并发症风险增加（aOR=8.52，95%CI：7.69-9.45）显著相关。衰弱是接受 PCNL 的老年患者不良围手术期结局的重要预后指标，这突显了识别和管理老年患者衰弱的重要性。
