Can the Modified Frailty Index (mFI) Predict Intraoperative and Postoperative Complications in Older Women with Endometrial Cancer Undergoing Laparoscopic or Robotic Surgery? A Multicenter Observational Study.

Autor: Schipa C; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.; Catholic University 'Sacro Cuore', 00168 Rome, Italy., Ripa M; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK.; Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy., Gallotta V; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Russo A; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.; Catholic University 'Sacro Cuore', 00168 Rome, Italy., Polidori L; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.; Catholic University 'Sacro Cuore', 00168 Rome, Italy., Fanfani F; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Capomacchia FM; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Corrado G; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Vizza E; Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, IRCCS 'Regina Elena' National Cancer Institute, 00144 Rome, Italy., Perrone AM; Division of Gynecologic Oncology, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy., Mereu L; Division of Obstetrics and Gynecology, Department of General Surgery and Medical-Surgical Specialism, University of Catania, CHIRMED Policlinico G. Rodolico, 95123 Catania, Italy., Cela V; Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy., Legge F; Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, 'F. Miulli' General Regional Hospital, Acquaviva delle Fonti, 70021 Bari, Italy., Hilaris G; 2nd Department of Gynecologic Oncology, Hygeia Hospital, Marousi, 15123 Athens, Greece.; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford University Hospital, Stanford, CA 94305, USA., Pasciuto T; Data Collection G-STeP Research Core Facility, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy., D'Indinosante M; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., La Fera E; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Certelli C; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Bruno V; Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, IRCCS 'Regina Elena' National Cancer Institute, 00144 Rome, Italy., Kogeorgos S; 2nd Department of Gynecologic Oncology, Hygeia Hospital, Marousi, 15123 Athens, Greece., De Iaco P; Division of Gynecologic Oncology, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy., Lathouras K; Department of Gynaecological Oncology, IASO General Hospital, Marousi, 15123 Athens, Greece., Sollazzi L; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.; Catholic University 'Sacro Cuore', 00168 Rome, Italy., Scambia G; Catholic University 'Sacro Cuore', 00168 Rome, Italy.; Gynecologic Oncology Unit, Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Aceto P; Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.; Catholic University 'Sacro Cuore', 00168 Rome, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Nov 21; Vol. 12 (23). Date of Electronic Publication: 2023 Nov 21.
DOI: 10.3390/jcm12237205
Abstrakt: Background: This study aims to evaluate the strength of the association between frailty and intraoperative/postoperative complications in patients undergoing minimally invasive surgery (MIS) for endometrial cancer.
Methods: In this retrospective observational multicenter cohort study, frailty was defined beforehand by a modified frailty index (mFI) score of ≥3. Multiple logistic regressions were performed to investigate possible preoperative predictors-including frailty, age, and body mass index-of intraoperative and early (within 30 days from surgery) or delayed (beyond 30 days from surgery) postoperative complications.
Results: The study involved 577 women, of whom 6.9% (n = 40) were frail with an mFI ≥ 3, while 93.1% (n = 537) were non-frail with an mFI of 0-2. Frail women had a significantly higher rate of intraoperative complications (7.5% vs. 1.7%, p = 0.01), with odds 4.54 times greater (95% CI: 1.18-17.60, p = 0.028). There were no differences in the rate of early postoperative complications (15% vs. 6.9%, p = 0.06) and delayed postoperative complications (2.5% vs. 3.9%, p = 0.65) for frail versus non-frail patients. The odds of early postoperative complications increased by 0.7% (95% CI: 1.00-1.15) for every one-unit increase in age ( p = 0.032).
Conclusions: Frailty was associated with a significantly higher risk of intraoperative complications in older women undergoing MIS for endometrial cancer. Likewise, increasing age was an independent predictor of early postoperative complications. Our findings support the practice of assessing frailty before surgery to optimize perioperative management in this patient population.
Databáze: MEDLINE
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