Self-reported exhaustion and a 4-item physical frailty index to predict the incidence of major complications after onco-geriatric surgery.

Autor: Scholtz K; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: kathrin.scholtz@charite.de., Borchers F; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: friedrich.borchers@charite.de., Mörgeli R; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: rudolf.moergeli@charite.de., Krampe H; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: henning.krampe@charite.de., Schmidt M; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Schlosspark-Klinik Berlin, Heubnerweg 2, 14059, Berlin, Germany. Electronic address: drschmidt.maren@web.de., Eckardt-Felmberg R; St. Joseph Krankenhaus Berlin-Tempelhof GmbH, Wüsthoffstraße 15, 12101, Berlin, Germany. Electronic address: rahel.eckardt-felmberg@sjk.de., von Dossow V; Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center NRW, Ruhr University Bochum, Georgstraße 11, 32545, Bad Oeynhausen, Germany. Electronic address: vvondossow@hdz-nrw.de., Sehouli J; Department of Gynecology, European Competence Center of Ovarian Cancer, Charité Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: jalid.sehouli@charite.de., Stief CG; Department of Urology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. Electronic address: christian.stief@med.uni-muenchen.de., Pohrt A; Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: anne.pohrt@charite.de., Spies CD; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: claudia.spies@charite.de.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Jul; Vol. 50 (7), pp. 108421. Date of Electronic Publication: 2024 May 23.
DOI: 10.1016/j.ejso.2024.108421
Abstrakt: Background: The aim of this study was to analyze four pre-operative physical frailty indicators from a geriatric assessment (GA) independently and combined in a physical frailty index, in their ability to predict postoperative 30 d-complications.
Materials and Methods: In this secondary analysis of data from the published PERATECS study (ClinicalTrials.gov: NCT01278537), the predictive value of four physical frailty indicators from a defined GA battery was examined with univariable and multivariate logistic regression models in a sample of 493 onco-geriatric surgical patients. The primary endpoint was incidence of major (Clavien-Dindo ≥ grade 2 [CD ≥ 2]) complications within 30 postoperative days. Predictors of the first model included self-reported exhaustion (SRE), body mass index (BMI), Timed Up-and-Go (TUG) and handgrip strength (HGS) independently, and a second model combined these four items as a Physical Frailty Index (4i-PFI). Both regression models were adjusted for age, gender, American Society of Anesthesiologists (ASA) status, tumor sites, duration of surgery time and Mini Nutritional Assessment (MNA) score.
Results: A total of 233 patients (47 %) developed CD ≥ 2 complications. In addition to ASA score, length of surgery, and gynecological and upper gastrointestinal tumor sites, the first model showed that SRE (OR 1.866) predicted CD ≥ 2 complications, but not TUG, BMI and HGS. In the second model, the 4i-PFI predicted CD ≥ 2 complications (OR pre-frail = 1.808, frail = 3.787).
Conclusions: Physical frailty indicators as SRE revealed a better ability to predict CD ≥ 2 complications than BMI, TUG and HGS. However, prediction of CD ≥ 2 complications was enhanced when these parameters were combined in a novel 4i-PFI.
Competing Interests: Declaration of competing interest The funders (German Cancer Aid) had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Dr. Maren Schmidt und Prof. Dr. Vera von Dossow received parts of their salary from the Deutsche Krebshilfe (German Cancer Aid; DKH-108474). Financial activities outside the submitted work are available to the Editorial Office. All conflicts of interests are declared. The ICMJE Form for Disclosure of Potential Conflicts of Interest and the EJSO author form are available to the Editorial Office. Univ.- Prof. Dr. C.D. Spies applied and received fundings from the Deutsche Krebshilfe (German Cancer Aid; DKH-108474) for outside payments. There are no patents, products in development or marketed products to declare.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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