Rehab Alsayari, Tyler McKechnie, Tania Kazi, Luke Heimann, Anjali Sachdeva, Yung Lee, Bright Huo, Niv Sne, Dennis Hong, Cagla Eskicioglu
{"title":"Modified Frailty Index for Patients Undergoing Surgery for Colorectal Cancer: Analysis of the National Inpatient Sample From 2015 to 2019.","authors":"Rehab Alsayari, Tyler McKechnie, Tania Kazi, Luke Heimann, Anjali Sachdeva, Yung Lee, Bright Huo, Niv Sne, Dennis Hong, Cagla Eskicioglu","doi":"10.1177/00031348241269398","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Frailty is increasingly recognized as a perioperative risk for numerous surgical diseases. We applied the modified frailty index (mFI-11) to the National Inpatient Sample (NIS) for patients undergoing surgery for colorectal cancer (CRC).</p><p><strong>Methods: </strong>We performed a retrospective analysis of the NIS (2015-2019) including CRC patients undergoing surgery. We classified patients into frail (ie, mFI ≥0.27) and robust (ie, mFI <0.27) categories. Primary outcomes were in-hospital postoperative morbidity and mortality. The secondary outcomes included system-specific postoperative morbidity and length of stay (LOS). Multivariable regression models were fit.</p><p><strong>Results: </strong>Within the 53,652 identified patients undergoing surgery for CRC, 19.1% were frail. Frail patients were at higher risk of postoperative mortality (3.1% vs 1.0%, odds ratio [OR] 1.96, 95% confidence intervals [CIs] 1.68-2.30, <i>P</i> < 0.001), morbidity (41.3 % vs 23.1%, OR 1.75, 95% CI 1.66-1.83, <i>P</i> < 0.001), and LOS (mean difference [MD] 1.46, 95% CI 0.29-1.62, <i>P</i> < 0.001). Significant differences existed between groups in system-specific postoperative morbidity, with the largest effect estimates seen in cardiovascular morbidities (OR 4.07, 95% CI 3.36-4.93, <i>P</i> = 0.001), followed by respiratory (OR 1.75, 95% CI 1.66-1.83, <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Frail patients undergoing CRC surgery are at risk of increased postoperative complications. Preoperative frailty screening may allow for individualized preoperative counseling.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":"91 1","pages":"76-85"},"PeriodicalIF":1.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Surgeon","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00031348241269398","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Frailty is increasingly recognized as a perioperative risk for numerous surgical diseases. We applied the modified frailty index (mFI-11) to the National Inpatient Sample (NIS) for patients undergoing surgery for colorectal cancer (CRC).
Methods: We performed a retrospective analysis of the NIS (2015-2019) including CRC patients undergoing surgery. We classified patients into frail (ie, mFI ≥0.27) and robust (ie, mFI <0.27) categories. Primary outcomes were in-hospital postoperative morbidity and mortality. The secondary outcomes included system-specific postoperative morbidity and length of stay (LOS). Multivariable regression models were fit.
Results: Within the 53,652 identified patients undergoing surgery for CRC, 19.1% were frail. Frail patients were at higher risk of postoperative mortality (3.1% vs 1.0%, odds ratio [OR] 1.96, 95% confidence intervals [CIs] 1.68-2.30, P < 0.001), morbidity (41.3 % vs 23.1%, OR 1.75, 95% CI 1.66-1.83, P < 0.001), and LOS (mean difference [MD] 1.46, 95% CI 0.29-1.62, P < 0.001). Significant differences existed between groups in system-specific postoperative morbidity, with the largest effect estimates seen in cardiovascular morbidities (OR 4.07, 95% CI 3.36-4.93, P = 0.001), followed by respiratory (OR 1.75, 95% CI 1.66-1.83, P = 0.001).
Conclusion: Frail patients undergoing CRC surgery are at risk of increased postoperative complications. Preoperative frailty screening may allow for individualized preoperative counseling.
期刊介绍:
The American Surgeon is a monthly peer-reviewed publication published by the Southeastern Surgical Congress. Its area of concentration is clinical general surgery, as defined by the content areas of the American Board of Surgery: alimentary tract (including bariatric surgery), abdomen and its contents, breast, skin and soft tissue, endocrine system, solid organ transplantation, pediatric surgery, surgical critical care, surgical oncology (including head and neck surgery), trauma and emergency surgery, and vascular surgery.