■脆弱预测手术患者的预后较差。最近的研究发现,社会经济地位是手术结果的重要特征。我们评估了区域剥夺指数(ADI)和社会脆弱性指数(SVI)的相关性,两个地理空间图集提供了对邻域剥夺的多维评估,在手术人群中身体虚弱。
■对接受常规虚弱筛查的患者进行了回顾性研究12/2020-8/2022。使用弗里德的虚弱表型(FFP)和五项改良虚弱指数(mFI-5)测量虚弱。使用患者住所确定ADI和SVI四分位数。使用Logistic回归模型评估FFP(仅虚弱vs不虚弱)和mFI-5(≥2vs0-1)与ADI和SVI的相关性(α=0.05)。
■在372名接受筛查的患者中,41%(154)是女性,中位年龄为68%(63-74),46%(170)被确定为非白人。在ADI和SVI四分位数中,更多的合并症,收入中位数下降,虚弱与剥夺感增加有关(p<0.01)。当控制年龄时,性别,合并症,和BMI类别,FFP的虚弱与ADI的最剥夺的两个四分位数有关(OR2.61,CI:[1.35-5.03],p<0.01)和SVI的最剥夺四分位数(OR2.33,[1.10-4.95],p<0.05)。这些趋势也可见于mFI-5评分≥2(ADI:OR1.64,[1.02-2.63],p<0.05;SVI:OR1.71,[1.01-2.91],p<0.05)。
■生活在社会经济贫困社区的手术患者更容易虚弱。干预措施可能包括对弱势群体进行筛查,并将资源分配给弱势群体。
UNASSIGNED: Frailty predicts poorer outcomes in surgical patients. Recent studies have found socioeconomic status to be an important characteristic for surgical outcomes. We evaluated the association of Area Deprivation Index (ADI) and Social Vulnerability Index (SVI), two geospatial atlases that provide a multidimensional evaluation of neighborhood deprivation, with frailty in a surgery population.
UNASSIGNED: A retrospective study of patients undergoing routine frailty screening was conducted 12/2020-8/2022. Frailty was measured using Fried\'s Frailty Phenotype (FFP) and the five-item Modified Frailty Index (mFI-5). ADI and SVI quartiles were determined using patient residence. Logistic regression models were used to evaluated associations of FFP (frail only vs not frail) and mFI-5 (≥2 vs 0-1) with ADI and SVI (α = 0.05).
UNASSIGNED: Of 372 screened patients, 41% (154) were women, median age was 68% (63-74), and 46% (170) identified as non-White. Across ADI and SVI quartiles, higher number of comorbidities, decreasing median income, and frailty were associated with increasing deprivation (p < 0.01). When controlling for age, sex, comorbidities, and BMI category, frailty by FFP was associated with the most deprived two quartiles of ADI (OR 2.61, CI: [1.35-5.03], p < 0.01) and the most deprived quartile of SVI (OR 2.33, [1.10-4.95], p < 0.05). These trends were also seen with mFI-5 scores ≥2 (ADI: OR 1.64, [1.02-2.63], p < 0.05; SVI: OR 1.71, [1.01-2.91], p < 0.05).
UNASSIGNED: Surgical patients living in socioeconomically deprived neighborhoods are more likely to be frail. Interventions may include screening of disadvantaged populations and resource allocation to vulnerable neighborhoods.