Abstract：
OBJECTIVE: The modified 5-item frailty index (mFI-5) is a comorbidity-based risk stratification tool previously validated in patients undergoing several surgical procedures. This study investigates the association between mFI-5 score and cricopharyngeal myotomy (CM) complications.
METHODS: Retrospective database review.
METHODS: US hospitals.
METHODS: The National Surgical Quality Improvement Program database was queried for patients who underwent CM between 2005 and 2018. mFI-5 score was determined by assigning 1 point for comorbidities including: diabetes mellitus, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dependent health status. Univariate and multivariable analyses were conducted to determine associations between mFI-5 score and postoperative complications.
RESULTS: A total of 1075 patients undergoing CMs were queried and stratified into the following groups: mFI = 0 (n = 412 [38.3%]), mFI = 1 (n = 452 [42.0%]), and mFI ≥ 2 (n = 211 [19.6%]). Univariate analysis showed association between higher mFI-5 scores with older age, higher American Society of Anesthesiologists Classification class, obesity, smoking, dyspnea, and systemic sepsis. Higher mFI-5 was associated with a greater proportion of cumulative surgical complications, cumulative medical complications, pneumonia, myocardial infarction, cumulative morbidity, readmissions, unplanned readmissions, and reoperations. Multivariable analyses found associations between greater mFI-5 score and cumulative morbidity (odds ratio [OR] = 1.95, confidence interval [CI]: 1.29-2.96, P = .002), any surgical complication (OR = 1.80, CI: 1.15-2.79, P = .010), readmission (OR = 1.81, CI: 1.01-3.26, P = .047), and reoperations (OR = 1.96, CI: 1.04-3.68, P = .037).
CONCLUSIONS: Evaluating mFI-5 can help assess the risk of postoperative complications for patients undergoing CM.
METHODS: Level 4.
METHODS: Retrospective database review.
METHODS: US hospitals.
METHODS: The National Surgical Quality Improvement Program database was queried for patients who underwent CM between 2005 and 2018. mFI-5 score was determined by assigning 1 point for comorbidities including: diabetes mellitus, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dependent health status. Univariate and multivariable analyses were conducted to determine associations between mFI-5 score and postoperative complications.
RESULTS: A total of 1075 patients undergoing CMs were queried and stratified into the following groups: mFI = 0 (n = 412 [38.3%]), mFI = 1 (n = 452 [42.0%]), and mFI ≥ 2 (n = 211 [19.6%]). Univariate analysis showed association between higher mFI-5 scores with older age, higher American Society of Anesthesiologists Classification class, obesity, smoking, dyspnea, and systemic sepsis. Higher mFI-5 was associated with a greater proportion of cumulative surgical complications, cumulative medical complications, pneumonia, myocardial infarction, cumulative morbidity, readmissions, unplanned readmissions, and reoperations. Multivariable analyses found associations between greater mFI-5 score and cumulative morbidity (odds ratio [OR] = 1.95, confidence interval [CI]: 1.29-2.96, P = .002), any surgical complication (OR = 1.80, CI: 1.15-2.79, P = .010), readmission (OR = 1.81, CI: 1.01-3.26, P = .047), and reoperations (OR = 1.96, CI: 1.04-3.68, P = .037).
CONCLUSIONS: Evaluating mFI-5 can help assess the risk of postoperative complications for patients undergoing CM.
METHODS: Level 4.
摘要：
目的：改良的5项虚弱指数（mFI-5）是一种基于合并症的风险分层工具，先前已在接受多种外科手术的患者中得到验证。本研究调查了mFI-5评分与环咽肌切开术（CM）并发症之间的关系。
方法：回顾性数据库回顾。
方法：美国医院。
方法：国家外科质量改进计划数据库查询了2005年至2018年接受CM的患者。mFI-5评分是通过为合并症分配1分来确定的，包括：糖尿病，高血压,充血性心力衰竭,慢性阻塞性肺疾病,和依赖的健康状况。进行单变量和多变量分析以确定mFI-5评分与术后并发症之间的关联。
结果：共查询1075例接受CM的患者，并将其分为以下几组：mFI=0（n=412[38.3％]），mFI=1(n=452[42.0%])，mFI≥2（n=211[19.6%]）。单变量分析显示，mFI-5评分较高与年龄增长相关，高等美国麻醉医师学会分类班，肥胖，吸烟,呼吸困难,和全身性败血症.更高的mFI-5与更大比例的累积手术并发症相关。累积的医疗并发症，肺炎,心肌梗塞,累积发病率，再入院,计划外再入院,和再操作。多变量分析发现更高的mFI-5评分与累积发病率之间存在关联（比值比[OR]=1.95，置信区间[CI]：1.29-2.96，P=.002），任何手术并发症（OR=1.80，CI：1.15-2.79，P=.010），再入院（OR=1.81，CI：1.01-3.26，P=0.047），和重新操作（OR=1.96，CI：1.04-3.68，P=0.037）。
结论：评估mFI-5有助于评估接受CM的患者术后并发症的风险。
方法：第4级。
方法：回顾性数据库回顾。
方法：美国医院。
方法：国家外科质量改进计划数据库查询了2005年至2018年接受CM的患者。mFI-5评分是通过为合并症分配1分来确定的，包括：糖尿病，高血压,充血性心力衰竭,慢性阻塞性肺疾病,和依赖的健康状况。进行单变量和多变量分析以确定mFI-5评分与术后并发症之间的关联。
结果：共查询1075例接受CM的患者，并将其分为以下几组：mFI=0（n=412[38.3％]），mFI=1(n=452[42.0%])，mFI≥2（n=211[19.6%]）。单变量分析显示，mFI-5评分较高与年龄增长相关，高等美国麻醉医师学会分类班，肥胖，吸烟,呼吸困难,和全身性败血症.更高的mFI-5与更大比例的累积手术并发症相关。累积的医疗并发症，肺炎,心肌梗塞,累积发病率，再入院,计划外再入院,和再操作。多变量分析发现更高的mFI-5评分与累积发病率之间存在关联（比值比[OR]=1.95，置信区间[CI]：1.29-2.96，P=.002），任何手术并发症（OR=1.80，CI：1.15-2.79，P=.010），再入院（OR=1.81，CI：1.01-3.26，P=0.047），和重新操作（OR=1.96，CI：1.04-3.68，P=0.037）。
结论：评估mFI-5有助于评估接受CM的患者术后并发症的风险。
方法：第4级。
