Frailty and Long-Term Mortality Following Emergency Laparotomy: A Comparison Between the 11-Item and 5-Item Modified Frailty Indices.

Autor: Park B; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand; Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, New Zealand. Electronic address: Brittany.park09@gmail.com., Vandal A; Department of Statistics, The University of Auckland, Auckland, New Zealand., Bhat S; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand., Welsh F; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand; Department of Surgery, Waikato Hospital, Te Whatu Ora, Auckland, New Zealand., Eglinton T; Department of Surgery, Christchurch Hospital, Te Whatu Ora, Auckland, New Zealand., Koea J; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand; Department of Surgery, North Shore Hospital, Te Whatu Ora, Auckland, New Zealand., Taneja A; Department of Surgery, Auckland City Hospital, Te Whatu Ora, Auckland, New Zealand., Hill AG; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand; Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, New Zealand., Barazanchi AWH; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand., MacCormick AD; Faculty of Medical and Health Sciences, The University of Auckland, Waipapa Taumata Rau, Auckland, New Zealand; Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, New Zealand. Electronic address: Andrew.maccormick@middlemore.co.nz.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2024 Nov; Vol. 303, pp. 40-49. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1016/j.jss.2024.07.106
Abstrakt: Introduction: Emergency laparotomy (EL) is a high-risk operation which is increasingly performed on an aging patient population. Objective frailty assessment using a validated index has the potential to improve preoperative risk stratification. This study aimed to assess the correlation between frailty and long-term mortality and morbidity outcomes for older EL patients. Secondary aims were to compare the 11-item and shortened five-item modified frailty indices (mFIs) in terms of value and predictive validity.
Methods: A prospective multicenter observational study of patients aged ≥55 y undergoing EL was conducted across five hospitals in New Zealand between 2017 and 2022. Frailty was measured using the 11-item and abbreviated five-item mFIs. Multivariable logistic regression was used to determine whether frailty was independently associated with one-year postoperative mortality and other morbidity outcomes. Correlation between the two frailty indices were assessed with the Spearman's correlation coefficient (P).
Results: Frailty assessments were performed in 861 participants, with the prevalence being 18.7% and 29.8% using the 11-item and five-item mFIs, respectively. Both frailty indices demonstrated similar associations with one-year mortality (two-fold increased risk), major complications, admission to intensive care unit, rehabilitation, and 30-d readmission. The 11-item mFI demonstrated a greater association with early mortality (four-fold increased risk), reoperations, and increased length of stay compared with the five-item frailty index. Spearman P was 0.6 (P < 0.001).
Conclusions: Frailty, as identified by the 11-item and five-item mFIs, was associated with one-year mortality and other important morbidity outcomes for older EL patients. These forms of frailty assessment provide important information that may aid in risk assessment and patient-centered decision-making.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: