| Autor: |
Li X; The Third Department of General Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China., Zheng J; Department of Clinical Epidemiology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China., Wei SB; The Seventh Department of General Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China., Li HY; The Third Department of General Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China., Jiang L; Department of General Surgery, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China., Dong L; Department of General Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China., Wang J; Department of General Surgery, Liaoning Provincial Health Industry Group Fukuang General Hospital, Fushun 113012, China., Tao CZ; Department of General Surgery, Liaoning Provincial Health Industry Group Fukuang General Hospital, Fushun 113012, China., Yan YH; Department of General Surgery, Dandong First Hospital, Dandong 118000, China., Sun LH; Department of General Surgery, the Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China., Cui LB; Department of General Surgery, Dalian Pulandian Geriatric Hospital, Dalian 116200, China., Huang JH; Department of General Surgery, Yingkou Central Hospital, Yingkou 115003, China., Fang YX; Department of General Surgery, Yingkou Central Hospital, Yingkou 115003, China., Tang CX; Department of General Surgery, Liaoyang Central Hospital, Liaoyang 111000, China. |
| Abstrakt: |
Objectives: To verify the reliability and validity of the frailty assessment scale for elderly patients with inguinal hernia and to evaluate the value of its clinical application. Methods: A convenience sampling method was used to collect 129 geriatric patients who underwent inguinal hernia surgery from January 2018 to January 2023 in nine hospitals in Liaoning Province. There were 120 males and 9 females, of whom 89 patients were 60 to <75 years old, 33 patients were 75 to <85 years old and 7 patients were ≥85 years old. The 129 patients included 11 elderly patients with inguinal hernia who had recovered from preoperative infection with COVID-19. Statistical methods such as Cronbach's coefficient, Kaiser-Meyer-Olkin test, Bartlett's test, Pearson's correlation analysis, etc. were calculated to verify the reliability indexes such as feasibility, content validity, structural validity, criterion-related validity, internal consistency reliability, and re-test reliability. Taking the 5-item modified frailty index (5-mFI) as the gold standard, the area under the curve was used to analyze the ability of the two scales to predict the occurrence of postoperative acute urinary retention, postoperative delirium, poor incision healing, operative hematoma seroma, and postoperative complications. Results: The frailty assessment scale for elderly patients with inguinal hernia showed good reliability and validity (valid completion rate of 99.2%; item content validity index of 1.000, and the scale content validity index of 1.000; exploratory factor analysis extracted a total of 1 principal component, and factor loadings of each item of 0.565 to 0.873; the AUC for frailty diagnosis using 5-mFI as the gold standard of 0.795 ( P <0.01) Cronbach's coefficient of 0.916, retest reliability coefficient of 0.926), it could effectively predict postoperative acute urinary retention, delirium, hematoma seroma in the operative area and total complications (AUC of 0.746, 0.870, 0.806, and 0.738, respectively; all P <0.05), and prediction efficiency was higher than that of 5-mFI (AUC of 0.694, 0.838, 0.626 and 0.641, P <0.05 for delirium only), but both scales were inaccurate in predicting poor incision healing (AUC of 0.519, P =0.913 for the frailty assessment scale and 0.455, P =0.791 for the 5-mFI). Conclusions: The frailty assessment scale for elderly patients with inguinal hernia is reliable and significantly predicts the occurrence of postoperative adverse events in elderly inguinal hernia patients. The scale can also be used for preoperative frailty assessment in elderly patients with inguinal hernia after rehabilitation from COVID-19 infection. |
