改良衰弱指数预测机器人辅助下老年前列腺癌根治术后并发症的临床应用

doi:10.3969/j.issn.1003-9198.2023.11.015

摘要/Abstract

摘要： 目的评估改良衰弱指数(modified frailty index,mFI)在预测机器人辅助下老年前列腺癌根治术后并发症中的应用。方法回顾性分析西安交通大学第二附属医院2019年6月至2022年10月择期行机器人辅助下前列腺癌根治术病人100例,依据mFI评分将病人分为衰弱组(mFI≥0.27)和非衰弱组(mFI<0.27)。统计分析2组病人的一般临床资料、mFI评分以及术后并发症发生率的差异;采用多因素Logistic回归分析术后并发症的影响因素。结果本研究共纳入符合标准的病人100例,其中衰弱组37例,非衰弱组63例;2组病人美国麻醉医师协会(ASA)分级和年龄差异均有统计学意义(P<0.05)。衰弱组病人心血管、呼吸以及神经系统的并发症发生率高于非衰弱组,差异有统计学意义(P<0.01)。多因素Logistic回归分析显示,衰弱是心血管系统(OR=7.344,95%CI:1.196～45.093,P=0.031)、呼吸系统(OR=5.849,95%CI:1.668～20.507,P=0.006)和神经系统并发症的独立危险因素(OR=5.521,95%CI:1.686～18.083,P=0.005)。结论 mFI评分可以作为评估机器人辅助下老年前列腺癌根治病人术前衰弱状态的有效工具。mFI≥0.27分的病人术后发生多系统并发症的风险相对增加。

关键词: 改良衰弱指数, 术后并发症, 老年人, 前列腺癌

Abstract: Objective To evaluate the application of modified frailty index(mFI) in predicting the complications after robot-assisted radical prostatectomy in the elderly patients. Methods A retrospective analysis was performed on the clinical data of 100 patients who underwent robot-assisted radical prostatectomy in the Second Affiliated Hospital of Xi 'an Jiaotong University from June 2019 to October 2022. According to mFI score, the patients were divided into the frailty group (mFI≥0.27) and the non-frailty group (mFI<0.27).The differences in general clinical data, mFI score and the incidence of postoperative complications between the two groups were analyzed. Multivariate Logistic regression analysis was performed to explore the risk factors of postoperative complications. Results A total of 100 patients meeting the criteria were enrolled in this study, including 37 cases in the frailty group and 63 cases in the non-frailty group. There were statistically significant differences in American Society of Anesthesiologists(ASA) grading and age between the two groups (P<0.05). The incidence rates of the complications in cardiovascular system, respiratory system and nervous system in frailty group were significantly higher than those in the non-frailty group (P<0.01). Multivariate Logistic regression analysis showed that the frailty was the independent risk factors for the complications in cardiovascular system (OR=7.344, 95%CI:1.196-45.093, P=0.031), respiratory system (OR=5.849, 95%CI: 1.668-20.507, P=0.006) and nervous system (OR=5.521, 95%CI:1.686-18.083, P=0.005). Conclusions mFI score can be used as an effective tool to evaluate the frailty state of the elderly patients undergoing robot-assisted radical prostatectomy. The patients with mFI≥0.27 have an increased risk of postoperative multisystem complications.

Key words: modified frailty index, postoperative complications, aged, prostate cancer

中图分类号:

R 737.25

艾英, 杨亚男, 孟丽华, 吕建瑞. 改良衰弱指数预测机器人辅助下老年前列腺癌根治术后并发症的临床应用[J]. 实用老年医学, 2023, 37(11): 1143-1146.

AI Ying, YANG Ya-nan, MENG Li-hua, LYU Jian-rui. Clinical application of improved frailty index to predict complications after radical prostatectomy assisted by robot in elderly patients[J]. Practical Geriatrics, 2023, 37(11): 1143-1146.

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