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Abstract：
BACKGROUND: To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI.
METHODS: Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected.
RESULTS: The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572-6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577-0.730] and GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery.
CONCLUSIONS: Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI.
BACKGROUND: This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/ .
METHODS: Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected.
RESULTS: The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572-6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577-0.730] and GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery.
CONCLUSIONS: Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI.
BACKGROUND: This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/ .
摘要：
背景：为了确定虚弱是否可以预测老年腹部手术患者的术后肠梗阻（PPOI）；并比较FRAIL量表的预测能力，PPOI的五点修正脆弱指数(mFI-5)和格罗宁根脆弱指标(GFI)。
方法：前瞻性纳入2022年4月至2023年1月在我们机构接受腹部大手术的患者（年龄≥65岁）。用FRAIL评估脆弱，手术前的mFI-5和GFI。人口统计数据，合并症,围手术期管理,收集术后肠功能恢复情况和PPOI发生情况。
结果：用FRAIL评估的虚弱发生率，mFI-5和GFI为18.2%，在总共203名患者中，38.4%和32.5%，分别。95（46.8％）患者经历了PPOI。通过三种量表评估的虚弱患者首次摄入软饮食的时间比没有虚弱的患者更长。通过mFI-5[比值比(OR)3.230,95%置信区间(CI)1.572-6.638,P=0.001]或GFI(OR2.627,95%CI1.307-5.281,P=0.007)诊断的虚弱与PPOI的风险较高有关。mFI-5[曲线下面积（AUC）0.653，95％CI0.577-0.730]和GFI（OR2.627，95％CI1.307-5.281，P=0.007）对腹部大手术患者的PPOI预测准确性不足。
结论：诊断为mFI-5或GFI虚弱的老年患者在腹部大手术后发生PPOI的风险增加。然而,mFI-5和GFI都不能准确识别将发展PPOI的个体。
背景：本研究已在中国临床试验注册中心注册（编号：ChiCTR2200058178).首次注册的日期，31/03/2022,https://www.chictr.org.cn/.
方法：前瞻性纳入2022年4月至2023年1月在我们机构接受腹部大手术的患者（年龄≥65岁）。用FRAIL评估脆弱，手术前的mFI-5和GFI。人口统计数据，合并症,围手术期管理,收集术后肠功能恢复情况和PPOI发生情况。
结果：用FRAIL评估的虚弱发生率，mFI-5和GFI为18.2%，在总共203名患者中，38.4%和32.5%，分别。95（46.8％）患者经历了PPOI。通过三种量表评估的虚弱患者首次摄入软饮食的时间比没有虚弱的患者更长。通过mFI-5[比值比(OR)3.230,95%置信区间(CI)1.572-6.638,P=0.001]或GFI(OR2.627,95%CI1.307-5.281,P=0.007)诊断的虚弱与PPOI的风险较高有关。mFI-5[曲线下面积（AUC）0.653，95％CI0.577-0.730]和GFI（OR2.627，95％CI1.307-5.281，P=0.007）对腹部大手术患者的PPOI预测准确性不足。
结论：诊断为mFI-5或GFI虚弱的老年患者在腹部大手术后发生PPOI的风险增加。然而,mFI-5和GFI都不能准确识别将发展PPOI的个体。
背景：本研究已在中国临床试验注册中心注册（编号：ChiCTR2200058178).首次注册的日期，31/03/2022,https://www.chictr.org.cn/.
