Li Yan, Du Juan, He Liu, Chen Ying, Liu Lili, Yan Han
Department of Nursing, The Second Affiliate Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, 610051, China.
Faculty of Medicine, Bioscience and Nursing, MAHSA University, Bandar Saujana Putra, Jenjarom, 42610, Selangor, Malaysia.
Aging Clin Exp Res. 2025 Jul 9;37(1):214. doi: 10.1007/s40520-025-03126-0.
This study aimed to explore the effect of frailty on postoperative complications in older patients with joint disorders and to examine the trajectory of frailty changes within three months post-surgery.
Older patients who were admitted for joint surgery from July to December 2023 were selected as study subjects. Data collected included general patient information, frailty scores, Age-adjusted Charlson Comorbidity Index (ACCI), Barthel Index and postoperative complications within 30 days after surgery. Frailty assessments were repeated at 1, 2, and 3 months post-surgery.
The incidence of postoperative complications was 32.5% and Frailty and ACCI were independent risk factors. The area under the curve (AUC) for predicting postoperative complications using frailty, ACCI, and their combination were 0.764, 0.747, and 0.814 respectively, with the combination showing superior predictive ability compared to ACCI alone (P < 0.05). Significant time and group effects were observed in frailty levels at the 1-, 2-, and 3-month postoperative time points between the complication and non-complication groups (P < 0.001), while the time-group interaction effect was not significant (P = 0.643).
Frailty serves as a valuable auxiliary predictor of postoperative complications in older patients with joint disorders.During the first 1-3 months after surgery, both the complication and non-complication groups exhibited similar declining trends in frailty levels but the former consistently showed higher frailty at each time point. Emphasis on frailty management is essential throughout the perioperative period and key stages of postoperative rehabilitation, with a dual focus on symptom management and frailty intervention in patients with complications to promote recovery.
本研究旨在探讨衰弱对老年关节疾病患者术后并发症的影响，并研究术后三个月内衰弱变化的轨迹。
选取2023年7月至12月因关节手术入院的老年患者作为研究对象。收集的数据包括患者一般信息、衰弱评分、年龄校正Charlson合并症指数（ACCI）、Barthel指数以及术后30天内的术后并发症。在术后1、2和3个月重复进行衰弱评估。
术后并发症发生率为32.5%，衰弱和ACCI是独立危险因素。使用衰弱、ACCI及其组合预测术后并发症的曲线下面积（AUC）分别为0.764、0.747和0.814，与单独使用ACCI相比，组合显示出更好的预测能力（P < 0.05）。在术后1、2和3个月的时间点，并发症组和非并发症组的衰弱水平存在显著的时间和组间效应（P < 0.001），而时间-组间交互效应不显著（P = 0.643）。
衰弱是老年关节疾病患者术后并发症的重要辅助预测指标。在术后1 - 3个月内，并发症组和非并发症组的衰弱水平均呈现相似的下降趋势，但前者在每个时间点的衰弱程度始终较高。在围手术期和术后康复的关键阶段，重视衰弱管理至关重要，对于并发症患者要同时关注症状管理和衰弱干预，以促进康复。
