PDF(Pubmed)
Abstract：
UNASSIGNED: Recently, determinants of frailty have become an increasingly recognized perioperative risk stratification tool. This study examines the predictive value of a 5-factor modified frailty index (mFI-5) on perioperative morbidity and mortality in patients undergoing otologic surgery, with a subgroup analysis based on surgery site.
UNASSIGNED: Cross-sectional analysis.
UNASSIGNED: National surgical quality improvement program dataset 2005-2019.
UNASSIGNED: Current procedural terminology (CPT) codes were used to identify patients undergoing all otologic surgeries.
UNASSIGNED: Otologic surgeries as indicated by CPT codes, including external ear, middle ear/mastoid, implants, and inner ear/facial nerve subgroups.
UNASSIGNED: Primary outcomes examined in this study included rates of overall complications and life-threatening complications within 30 days after surgery. Overall complications included superficial surgical site infections (SSI), deep incisional SSI, readmission, deep vein thrombosis, life-threatening complications, and mortality. Life-threatening complications included those classified as Clavien-Dindo grade IV: cerebrovascular accident, mechanical ventilation for more than 48 hours, reintubation, pulmonary embolism, acute renal failure, cardiac arrest, and myocardial infarction.
UNASSIGNED: A total of 16,859 patients who underwent otologic surgery were identified, resulting in a cohort that was 47.5% male with an average age of 47.6 years (17.1 SD). Multivariable regression analysis of the entire cohort demonstrated a score of 3 or more on the mFI-5 was independently predictive of all postoperative complications (odds ratio (OR): 2.02, P < 0.0001). However, subgroup analysis showed that only \"external ear\" surgery correlated with mFi-5 (OR 8.03, P = 0.013).
UNASSIGNED: Higher frailty scores as measured by the mFI-5 correlate with postoperative morbidity and mortality after otologic surgery, though subgroup analysis reveals an association only with cases performed on the external ear. These findings suggest that for most otologic surgery, the mFI-5 frailty score is not predictive of postoperative complications.
UNASSIGNED: Cross-sectional analysis.
UNASSIGNED: National surgical quality improvement program dataset 2005-2019.
UNASSIGNED: Current procedural terminology (CPT) codes were used to identify patients undergoing all otologic surgeries.
UNASSIGNED: Otologic surgeries as indicated by CPT codes, including external ear, middle ear/mastoid, implants, and inner ear/facial nerve subgroups.
UNASSIGNED: Primary outcomes examined in this study included rates of overall complications and life-threatening complications within 30 days after surgery. Overall complications included superficial surgical site infections (SSI), deep incisional SSI, readmission, deep vein thrombosis, life-threatening complications, and mortality. Life-threatening complications included those classified as Clavien-Dindo grade IV: cerebrovascular accident, mechanical ventilation for more than 48 hours, reintubation, pulmonary embolism, acute renal failure, cardiac arrest, and myocardial infarction.
UNASSIGNED: A total of 16,859 patients who underwent otologic surgery were identified, resulting in a cohort that was 47.5% male with an average age of 47.6 years (17.1 SD). Multivariable regression analysis of the entire cohort demonstrated a score of 3 or more on the mFI-5 was independently predictive of all postoperative complications (odds ratio (OR): 2.02, P < 0.0001). However, subgroup analysis showed that only \"external ear\" surgery correlated with mFi-5 (OR 8.03, P = 0.013).
UNASSIGNED: Higher frailty scores as measured by the mFI-5 correlate with postoperative morbidity and mortality after otologic surgery, though subgroup analysis reveals an association only with cases performed on the external ear. These findings suggest that for most otologic surgery, the mFI-5 frailty score is not predictive of postoperative complications.
摘要：
■最近，虚弱的决定因素已成为越来越被认可的围手术期风险分层工具.这项研究检查了5因素改良的虚弱指数（mFI-5）对接受耳科手术的患者围手术期发病率和死亡率的预测价值。根据手术部位进行亚组分析。
■横截面分析。
■2005-2019年全国手术质量改进计划数据集。
■目前的手术术语(CPT)代码被用于识别接受所有耳科手术的患者。
■由CPT代码指示的耳科手术，包括外耳,中耳/乳突，植入物,和内耳/面神经亚组。
■本研究检查的主要结果包括手术后30天内的总体并发症和危及生命的并发症的发生率。总体并发症包括浅表手术部位感染（SSI），深切口SSI,重新接纳,深静脉血栓形成,危及生命的并发症,和死亡率。危及生命的并发症包括Clavien-DindoIV级：脑血管意外，机械通气超过48小时，再插管,肺栓塞,急性肾功能衰竭,心脏骤停,和心肌梗塞。
■共有16859例患者接受了耳科手术，导致队列中男性占47.5％，平均年龄为47.6岁（17.1SD）。整个队列的多因素回归分析显示mFI-5评分为3分或以上是所有术后并发症的独立预测因素(比值比(OR):2.02,P<0.0001)。然而,亚组分析显示，仅“外耳”手术与mFi-5相关（OR8.03，P=0.013）。
■通过mFI-5测量的更高的虚弱评分与耳科手术后的发病率和死亡率相关，尽管亚组分析显示仅与外耳病例相关。这些发现表明，对于大多数耳科手术，mFI-5衰弱评分不能预测术后并发症.
■横截面分析。
■2005-2019年全国手术质量改进计划数据集。
■目前的手术术语(CPT)代码被用于识别接受所有耳科手术的患者。
■由CPT代码指示的耳科手术，包括外耳,中耳/乳突，植入物,和内耳/面神经亚组。
■本研究检查的主要结果包括手术后30天内的总体并发症和危及生命的并发症的发生率。总体并发症包括浅表手术部位感染（SSI），深切口SSI,重新接纳,深静脉血栓形成,危及生命的并发症,和死亡率。危及生命的并发症包括Clavien-DindoIV级：脑血管意外，机械通气超过48小时，再插管,肺栓塞,急性肾功能衰竭,心脏骤停,和心肌梗塞。
■共有16859例患者接受了耳科手术，导致队列中男性占47.5％，平均年龄为47.6岁（17.1SD）。整个队列的多因素回归分析显示mFI-5评分为3分或以上是所有术后并发症的独立预测因素(比值比(OR):2.02,P<0.0001)。然而,亚组分析显示，仅“外耳”手术与mFi-5相关（OR8.03，P=0.013）。
■通过mFI-5测量的更高的虚弱评分与耳科手术后的发病率和死亡率相关，尽管亚组分析显示仅与外耳病例相关。这些发现表明，对于大多数耳科手术，mFI-5衰弱评分不能预测术后并发症.
