改良衰弱指数联合外科Apgar评分对腹腔镜结直肠癌根治术老年患者术后并发症的预测效能OA北大核心CSTPCD
Modified frailty index combined with surgical Apgar score for predicting postoperative complications in elderly patients undergoing laparoscopic radical resection of colorectal cancer
目的 探讨11项改良衰弱指数(mFI-11)联合外科Apgar评分(SAS)对腹腔镜结直肠癌根治术老年患者发生术后并发症的预测效能.方法 纳入腹腔镜结直肠癌根治术老年(年龄≥65岁)患者481例.术前采用mFI-11完成衰弱评估.根据术中最低平均动脉压、最低心率和估计失血量,计算SAS.比较有术后并发症和无术后并发症患者的临床资料、mFI-11、SAS,分析mFI-11、SAS与术后并发症的关系及其预测价值.结果 mFI-11、SAS、手术时间与术后并发症的发生独立相关(P<0.05),三者预测术后并发症的曲线下面积(AUC)分别为0.805、0.800、0.610,mFI-11联合SAS预测术后并发症的AUC为0.902.结论 在腹腔镜结直肠癌根治术老年患者中,mFI-11、SAS、手术时间与术后并发症的发生显著相关,且mFI-11联合SAS对术后并发症有较高的预测效能,优于单一指标,能够为临床早期识别以及减少并发症的发生提供可靠依据.
Objective To explore the efficacy of an 11-item modified frailty index(mFI-11)combined with surgical Apgar score(SAS)for predicting postoperative complications in elderly patients with colorectal cancer undergoing laparoscopic radical resection.Methods We enrolled a total of 481 elderly patients(aged≥65 years)undergoing laparoscopic radical resection of colorectal cancer.We performed a frailty assessment preoperatively using mFI-11 and calculated the SAS based on the lowest mean arterial pressure and heart rate as well as blood loss during surgery.Finally,we compared the clinical data,mFI-11,and SAS of patients with and without post-operative complications,and then analyzed their relationship with the postoperative complications and predictive values.Results The mFI-11,SAS,and operation time independently correlated with postoperative complication occurrence(P<0.05).The AUC of post-operative complications obtained using the mFI-11,SAS,and operation time were 0.805,0.800,and 0.610,respectively.The AUC of the postoperative complications derived from mFI-11 combined with SAS was 0.902.Conclusion In elderly patients undergoing laparo-scopic radical resection of colorectal cancer,the mFI-11,SAS,and operation time significantly correlated with postoperative complication occurrence.The combination of mFI-11 and SAS displayed a higher predictive power for postoperative complications compared to the use of a single indicator,which it could provide a reliable basis for early clinical identification of complications and reduce their occurrence.
杨新霞;徐霞;陈冬冬
宁波市医疗中心李惠利医院麻醉科,浙江 宁波 315100
临床医学
衰弱Apgar评分术后并发症
frailtyApgar scorepostoperative complication
《中国医科大学学报》 2024 (007)
616-620 / 5
浙江省中医药科技计划(2024ZL941)
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