NSQIP 5-factor modified frailty index and complications after ileal anal pouch anastomosis for ulcerative colitis.
| Autor: | Thompson DT; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America., Breyfogle EG; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America., Tran CG; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America., Suraju MO; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America., Mishra A; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America., Lanewalla HA; Aga Khan University, Karachi, Pakistan., Goffredo P; Division of Colon & Rectal Surgery, University of Minnesota, Minneapolis, MN, United States of America., Hassan I; Department of Surgery, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52241, United States of America. |
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| Jazyk: | angličtina |
| Zdroj: | Surgery open science [Surg Open Sci] 2024 Mar 28; Vol. 19, pp. 95-100. Date of Electronic Publication: 2024 Mar 28 (Print Publication: 2024). |
| DOI: | 10.1016/j.sopen.2024.03.011 |
| Abstrakt: | Background: Frailty has been associated with worse postoperative outcomes. The 5-factor modified frailty index (mFI-5) is an objective measure although its validity in measuring frailty in patients undergoing ileal pouch-anal anastomosis (IPAA) for chronic ulcerative colitis (CUC) has not been reported. Methods: This study used the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) targeted proctectomy database. The mFI-5 was calculated by five preoperative diagnoses: insulin-dependent or noninsulin-dependent diabetes, congestive heart failure, hypertension, chronic obstructive pulmonary disease, and dependent or partially dependent functional status. The impact of mFI-5 on minor and major postoperative morbidity in CUC patients undergoing IPAA was analyzed. Results: The cohort included 1454 patients (median age 38 years, median body mass index [BMI] 26 kg/m2) of which 87 % had a mFI-5 = 0, 11 % had a mFI-5 = 1, and 2.5 % a mFI-5 ≥ 2. In multivariable logistic regression, mFI-5 ≥ 2 was significantly associated with minor complications (OR = 2.29, 95 % CI [1.00-5.22], p = 0.049), but not with major complications ( p = 0.860). Conclusion: IPAA for CUC is associated with high postoperative morbidity, however, the mFI-5 alone has limited utility in determining which patients are at a higher risk of complications due to frailty. These observations suggest there is a need for more relevant instruments to measure frailty in this patient cohort. Competing Interests: The authors have no conflicts of interest to declare. (© 2024 Published by Elsevier Inc.) |
| Databáze: | MEDLINE |
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