Abstract：
Objectives: To verify the reliability and validity of the frailty assessment scale for elderly patients with inguinal hernia and to evaluate the value of its clinical application. Methods: A convenience sampling method was used to collect 129 geriatric patients who underwent inguinal hernia surgery from January 2018 to January 2023 in nine hospitals in Liaoning Province. There were 120 males and 9 females, of whom 89 patients were 60 to <75 years old, 33 patients were 75 to <85 years old and 7 patients were ≥85 years old. The 129 patients included 11 elderly patients with inguinal hernia who had recovered from preoperative infection with COVID-19. Statistical methods such as Cronbach\'s coefficient, Kaiser-Meyer-Olkin test, Bartlett\'s test, Pearson\'s correlation analysis, etc. were calculated to verify the reliability indexes such as feasibility, content validity, structural validity, criterion-related validity, internal consistency reliability, and re-test reliability. Taking the 5-item modified frailty index (5-mFI) as the gold standard, the area under the curve was used to analyze the ability of the two scales to predict the occurrence of postoperative acute urinary retention, postoperative delirium, poor incision healing, operative hematoma seroma, and postoperative complications. Results: The frailty assessment scale for elderly patients with inguinal hernia showed good reliability and validity (valid completion rate of 99.2%; item content validity index of 1.000, and the scale content validity index of 1.000; exploratory factor analysis extracted a total of 1 principal component, and factor loadings of each item of 0.565 to 0.873; the AUC for frailty diagnosis using 5-mFI as the gold standard of 0.795 (P<0.01) Cronbach\'s coefficient of 0.916, retest reliability coefficient of 0.926), it could effectively predict postoperative acute urinary retention, delirium, hematoma seroma in the operative area and total complications (AUC of 0.746, 0.870, 0.806, and 0.738, respectively; all P<0.05), and prediction efficiency was higher than that of 5-mFI (AUC of 0.694, 0.838, 0.626 and 0.641, P<0.05 for delirium only), but both scales were inaccurate in predicting poor incision healing (AUC of 0.519, P=0.913 for the frailty assessment scale and 0.455, P=0.791 for the 5-mFI). Conclusions: The frailty assessment scale for elderly patients with inguinal hernia is reliable and significantly predicts the occurrence of postoperative adverse events in elderly inguinal hernia patients. The scale can also be used for preoperative frailty assessment in elderly patients with inguinal hernia after rehabilitation from COVID-19 infection.
目的： 对老年腹股沟疝患者衰弱评估量表进行信效度检验和临床应用价值评价。 方法： 采用方便抽样法收集2018年1月至2023年1月在辽宁省9家医院行腹股沟疝手术的129例老年患者资料。男性120例，女性9例；年龄60~<75岁89例，75~<85岁33例，85岁及以上7例；术前感染新型冠状病毒后康复者11例。通过计算克朗巴哈系数和验证性因子分析等统计学方法验证衰弱评估量表的信效度，以5项改良衰弱指数量表（5-mFI）作为金标准，使用受试者工作特征曲线下面积（AUC）评价两种量表对术后发生急性尿潴留、谵妄、切口愈合不良、术区血肿血清肿和总并发症的预测能力。 结果： 老年腹股沟疝患者衰弱评估量表具备较好的信效度（有效完成率为99.2%；各条目的内容效度为1.000，量表的全体一致内容效度为1.000；探索性因子分析共提取1个主成分，各条目因子载荷为0.565~0.873；以5-mFI诊断衰弱作为金标准，AUC为0.795，P<0.01；克朗巴哈系数为0.916；重测信度系数为 0.926），可以有效预测术后急性尿潴留、谵妄、术区血肿血清肿和总并发症（AUC分别为0.746、0.870、0.806和0.738，P值均<0.05），且预测效率高于5-mFI（AUC分别为0.694、0.838、0.626和0.641，仅谵妄一项P<0.05），但两种量表对切口愈合不良的预测均不准确（衰弱量表的AUC为0.519，P=0.913；5-mFI的AUC为0.455，P=0.791）。 结论： 老年腹股沟疝患者衰弱评估量表具备良好的信效度，能够预测老年腹股沟疝患者术后并发症的发生。该量表还可用于感染新型冠状病毒康复后的老年腹股沟疝患者的术前衰弱评估。.
目的： 对老年腹股沟疝患者衰弱评估量表进行信效度检验和临床应用价值评价。 方法： 采用方便抽样法收集2018年1月至2023年1月在辽宁省9家医院行腹股沟疝手术的129例老年患者资料。男性120例，女性9例；年龄60~<75岁89例，75~<85岁33例，85岁及以上7例；术前感染新型冠状病毒后康复者11例。通过计算克朗巴哈系数和验证性因子分析等统计学方法验证衰弱评估量表的信效度，以5项改良衰弱指数量表（5-mFI）作为金标准，使用受试者工作特征曲线下面积（AUC）评价两种量表对术后发生急性尿潴留、谵妄、切口愈合不良、术区血肿血清肿和总并发症的预测能力。 结果： 老年腹股沟疝患者衰弱评估量表具备较好的信效度（有效完成率为99.2%；各条目的内容效度为1.000，量表的全体一致内容效度为1.000；探索性因子分析共提取1个主成分，各条目因子载荷为0.565~0.873；以5-mFI诊断衰弱作为金标准，AUC为0.795，P<0.01；克朗巴哈系数为0.916；重测信度系数为 0.926），可以有效预测术后急性尿潴留、谵妄、术区血肿血清肿和总并发症（AUC分别为0.746、0.870、0.806和0.738，P值均<0.05），且预测效率高于5-mFI（AUC分别为0.694、0.838、0.626和0.641，仅谵妄一项P<0.05），但两种量表对切口愈合不良的预测均不准确（衰弱量表的AUC为0.519，P=0.913；5-mFI的AUC为0.455，P=0.791）。 结论： 老年腹股沟疝患者衰弱评估量表具备良好的信效度，能够预测老年腹股沟疝患者术后并发症的发生。该量表还可用于感染新型冠状病毒康复后的老年腹股沟疝患者的术前衰弱评估。.
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