The modified frailty index-11 predicts medium-term outcomes after endovascular revascularisation for chronic limb threatening ischaemia in Asian patients.

Autor: Soon SX; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore., D'Çruz R; National University Hospital, Singapore, Singapore., Yap CJ; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore., Tay WL; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore., Chng SP; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore., Choke ET; Department of General Surgery, Sengkang General Hospital, Singapore, Singapore., Chong TT; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore., Wong TH; Department of General Surgery, Singapore General Hospital, Singapore, Singapore., Tang TY; Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore.; Duke NUS Medical Graduate School, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Vascular [Vascular] 2022 Feb; Vol. 30 (1), pp. 42-51. Date of Electronic Publication: 2021 Jan 24.
DOI: 10.1177/1708538120988228
Abstrakt: Objective: The aim was to evaluate the utility of frailty, as defined by the modified Frailty Index-1 1 (mFI-11) on predicting outcomes following endovascular revascularisation in Asian patients with chronic limb-threatening ischaemia (CLTI).
Methods: CLTI patients who underwent endovascular revascularisation between January 2015 and March 2017 were included. Patients were retrospectively scored using the mFI-11 to categorise frailty as low, medium or high risk. Observed outcomes included 30-day complication rate and unplanned readmissions, 1-, 6- and 12-month mortality, and ambulation status at 6- and 12 months post-intervention.
Results: A total of 233 patients (250 procedures) were included; 137 (58.8%) were males and the mean age was 69.0 (±10.7) years. 202/233 (86.7%) were diabetic and 196/233 (84.1%) had a prior diagnosis of peripheral arterial disease (PAD). The mean mFI-11 score was 4.2 (±1.5). 28/233 (12.0%), 155/233 (66.5%), and 50/233 (21.5%) patients were deemed low (mF-11 score 0-2), moderate (mFI-11 score 3-5) and high (mFI-11 score 5-7) frailty risk, respectively. High frailty was associated with an increased 12-month mortality (OR 8.54, 95% CI 1.05-69.5; p  = 0.05), 30-day complication rate (OR 9.41, 95% CI 2.01-44.1; p  < 0.01) and 30-day unplanned readmission (OR 5.06, 95% CI 1.06-24.2; p  = 0.04). Furthermore, a high score was associated with a significantly worse 6- (OR 0.320, 95% CI 0.120-0.840; p  = 0.02) and 12-month (OR 0.270, 95% CI 0.100-0.710; p  < 0.01) ambulatory status.
Conclusion: The mFI-11 is a useful, non-invasive tool that can be readily calculated using readily available patient data, for prediction of medium-term outcomes for Asian CLTI patients following endovascular revascularisation. Early recognition of short- and mid-term loss of ambulation status amongst high-frailty patients in this challenging cohort of patients could aid decision-making for whether a revascularisation or amputation-first policy is appropriate, and manage patient and caregiver expectations on potential improvement in functional outcome.
Databáze: MEDLINE
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