Your browser doesn't support javascript.
loading
Association Between the Modified Frailty Index and Outcomes Following Lobectomy.
Bludevich, Bryce M; Emmerick, Isabel; Uy, Karl; Maxfield, Mark; Ash, Arlene S; Baima, Jennifer; Lou, Feiran.
Afiliação
  • Bludevich BM; Division of Thoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Emmerick I; Division of Thoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Uy K; Division of Thoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Maxfield M; Division of Thoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Ash AS; Department of Quantitative Health Services, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Baima J; Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts.
  • Lou F; Division of Thoracic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: feiran.lou@umassmemorial.org.
J Surg Res ; 283: 559-571, 2023 Mar.
Article em En | MEDLINE | ID: mdl-36442255
INTRODUCTION: Elective thoracic surgery is safe in well-selected elderly patients. The association of frailty with postoperative morbidity in elective-lobectomy patients is understudied. We examined frailty as defined by abbreviated modified frailty index (mFI-5), mFI-11 in the thoracic surgery population, and the correlation between frailty and postoperative complications. METHODS: We studied outcomes of patients in two cohorts, 2010-2012 and 2013-2019, from the National Surgical Quality Improvement Program (NSQIP) database and used multivariable logistic regression models to predict all postoperative morbidity, mortality, and major morbidity. The mFI-5 could be calculated for all subjects (both 2010-2012, and 2013-2019); the mFI-11 could only be calculated for the 2010-2012 cohort. Patient frailty was defined as mFI≥3 (with either index). We used odds ratios (ORs) to examine associations of preoperative characteristics with postoperative complications and C-statistics to assess overall predictive power. RESULTS: Complications were less prevalent in the 2013-2019 cohort (17.9% versus 19.5%, P = 0.008). Open lobectomies were more common in the 2010-2012 cohort (53.9% versus 34.6%) and were strongly associated with postoperative morbidity and mortality (ORs >1.5) in both cohorts. Each frailty measure was associated with morbidity and mortality (ORs >1.4) after adjusting for other significant preoperative factors. Models on the 2010-2012 cohort had nearly identical C-statistics using the mFI-11 versus mFI-5 frailty indices (0.6142 versus 0.6139; P > 0.8). CONCLUSIONS: Frailty, as captured in the mFI-5, is a significant associated factor of postoperative morbidity and mortality following elective lobectomies. As a modifiable risk factor, frailty should be considered in surgical decision-making and when counseling patients regarding perioperative risks.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fragilidade Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fragilidade Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article