Hospital frailty risk score predicts postoperative outcomes after endoscopic endonasal resection of non-functioning pituitary adenomas.

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2025-02-03 DOI:10.1007/s11102-024-01496-8

Foad Kazemi, Jiaqi Liu, Megan Parker, Adrian E Jimenez, A Karim Ahmed, Roberto Salvatori, Amir H Hamrahian, Nicholas R Rowan, Murugappan Ramanathan, Nyall R London, Masaru Ishii, Jordina Rincon-Torroella, Gary L Gallia, Debraj Mukherjee

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引用次数: 0

Abstract

Purpose: Frailty indices are invaluable resources in risk stratification and predicting high-value care outcomes for neurosurgical patients. The Hospital Frailty Risk Score (HFRS) is a recently developed and validated method for evaluating frailty; however, its implementation has yet to be assessed in patients with non-functioning pituitary adenomas undergoing endoscopic endonasal resection. In this study, we aimed to evaluate HFRS's predictive ability for high-value care outcomes, namely postoperative complications, length of stay (LOS), and hospital charges, and to compare it to other traditionally used frailty indices.

Methods: A retrospective review of electronic medical records from 2017 to 2020. A total of 109 ICD-10 codes corresponding to various frailty-related conditions were used to identify the components of HFRS. These components were then used to calculate the HFRS for each patient, with higher scores indicative of elevated frailty. Standard multivariate logistic regression models were employed to explore the association between HFRS and high-value care outcomes. Model discrimination was assessed using the area under the ROC curves, and the DeLong test was used to compare AUCs.

Results: A total of 172 patients were included, with a mean age of 57.27 ± 12.95 years and an average HFRS score of 3.65 $\pm$ 3.27. Among patients, 56% were male, 5.2% experience postoperative complications, 23.3% endured extended LOS, 25.0% incurred high hospital charges. In multivariate regression models, greater HFRS was significantly and independently associated with postoperative complications (OR = 1.51, P < 0.001), extended LOS (OR = 1.17, P = 0.006) and high hospital charges (OR = 1.18, P = 0.004). HFRS had the highest AUC compared to other frailty indices and was the most parsimonious model, with AUC values of 0.82, 0.64, and 0.63 for predicting complications, extended LOS, and higher charges, respectively.

Conclusion: Higher HFRS scores are significantly associated with postoperative complications, prolonged LOS, and high hospital charges for patients undergoing pituitary surgery.

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目的：虚弱指数是对神经外科患者进行风险分层和预测高价值护理结果的宝贵资源。医院虚弱风险评分（Hospital Frailty Risk Score，HFRS）是最近开发并验证的一种评估虚弱程度的方法；然而，该方法在接受内镜下垂体腺瘤切除术的无功能垂体腺瘤患者中的应用尚未得到评估。在本研究中，我们旨在评估 HFRS 对高价值护理结果（即术后并发症、住院时间（LOS）和住院费用）的预测能力，并将其与其他传统使用的虚弱指数进行比较：对 2017 年至 2020 年的电子病历进行回顾性分析。共使用 109 个 ICD-10 编码对应各种虚弱相关病症，以确定 HFRS 的组成部分。然后用这些成分来计算每位患者的 HFRS，分数越高表明虚弱程度越高。采用标准多变量逻辑回归模型来探讨 HFRS 与高价值护理结果之间的关联。使用 ROC 曲线下面积评估模型的区分度，并使用 DeLong 检验比较 AUC：共纳入 172 名患者，平均年龄（57.27±12.95）岁，HFRS 平均得分（3.65±3.27）分。其中，56%的患者为男性，5.2%的患者出现术后并发症，23.3%的患者延长了住院时间，25.0%的患者产生了高额住院费用。在多变量回归模型中，HFRS 越高，术后并发症越多（OR = 1.51，P 结论：HFRS 越高，术后并发症越多：HFRS评分越高，垂体手术患者的术后并发症、长期住院时间和高额住院费用就越明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.