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。
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.