Outcome Analysis Using the Modified Frailty Index-5 in Patients With Complex Aortoiliac Disease
| Autor: | Hugo Ribeiro, Pedro Paz Dias, Luís Duarte-Gamas, José Vidoedo, António Pereira-Neves, Leandro Nóbrega, João Rocha-Neves, Ana Azevedo-Cerqueira, José A. Teixeira |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Frail Elderly Health Status Population Aortic Diseases Aortoiliac occlusive disease Arterial Occlusive Diseases Comorbidity Iliac Artery Risk Assessment Postoperative Complications Risk Factors Internal medicine medicine Humans Prospective Studies Registries education Adverse effect Survival analysis Aged education.field_of_study Frailty business.industry Endovascular Procedures Hazard ratio Age Factors General Medicine Middle Aged Vascular surgery medicine.disease Treatment Outcome Female Surgery Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures Mace Kidney disease |
| Zdroj: | Annals of Vascular Surgery. 79:153-161 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.06.049 |
| Popis: | OBJECTIVES Vascular surgery patients commonly have several comorbidities that cumulatively lead to a frailty status. The cumulative comorbidities disproportionately increase the risk of adverse events and are also associated with worsened long-term prognosis. In recent years, several tools have been elaborated with the objective of quantifying a patient's frailty. One of them is the modified frailty index-5 (mFI-5), a simplified and easy to use index. There is scarce data regarding its value as a prognostic factor in aortoiliac occlusive disease. The aim of this work is to validate mFI-5 as a potential postoperative prognostic indicator in this population. METHODS From January 2013 to January 2020, 109 patients who underwent elective revascularizations, either endovascular or open surgery, having Trans-Atlantic Inter-Society Consensus II type D aortoiliac lesions in a tertiary and a regional hospital were selected from a prospective vascular registry. Demographic data was collected including diabetes mellitus, chronic heart failure, chronic obstructive pulmonary disease, arterial hypertension requiring medication and functional status. The 30-day and subsequent long-term surveillance outcomes were also collected including major adverse cardiovascular events (MACE), major adverse limb events (MALE) and all-cause mortality were assessed in the 30-days post-procedure and in the subsequent long-term surveillance period. The mFI-5 was applied to this population to evaluate the prognostic impact of this frailty marker on mortality and morbidity. RESULTS In the long-term follow-up, mFI-5 was significantly associated with MACE (hazard ratio [HR] 2.469; 95% confidence interval [CI]: 1.267-4.811; P = 0.008) and all-cause mortality (HR 2.585; 95% CI: 1.270-5.260; P = 0.009). However, there was no significant association with 30-day outcomes. Along with the presence of chronic kidney disease, mFI-5 was the prognostic factor better able of predicting MACE. No prognostic value was found regarding short-term outcomes. CONCLUSION The mFI-5 index may have a role in predicting long term outcomes, namely MACE and all-cause mortality, in the subset of patients with extensive aortoiliac occlusive disease. Its ease of use can foster its application in risk stratification and contribute for the decision-making process. |
| Databáze: | OpenAIRE |
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