Yang Li, Yujie Li, Chuanchuan Zhuo, Shi Shen, Naiqiang Zhuo
{"title":"Predictive value of the hospital frailty risk score in perioperative complications of artificial hip and knee arthroplasty in elderly patients.","authors":"Yang Li, Yujie Li, Chuanchuan Zhuo, Shi Shen, Naiqiang Zhuo","doi":"10.1177/09287329241296769","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundAlthough artificial hip and knee arthroplasty has been widely used, the incidence of perioperative complications remains relatively high due to factors such as long operation time and large surgical incisions. However, the Hospital Frailty Risk Score (HFRS) clinical value for patients undergoing artificial hip and knee arthroplasty in China is not yet clear. This study aims to explore its clinical value in this population.ObjectiveTo explore predictive value of the HFRS in perioperative complications of artificial hip and knee arthroplasty in elderly patients.MethodsElderly patients who underwent artificial hip and knee arthroplasty in our hospital from March 2020 to March 2022 were selected as the study subjects. The patients were divided into the non-frail risk group (HFRS <5 points) and the frail risk group (HFRS ≥5 points) on the basis of the literature grading method. 5-factor modified frailty index (mFI-5) and Charlson Comorbidity Index (CCI) scores were assessed. General data including age, sex, ASA classification, preoperative course, and surgical time were collected through the electronic medical record system. The occurrence of postoperative deep venous thrombosis, periprosthetic infection, hematoma, anemia, and overall complications was recorded. Hospitalization days, surgical costs, and total treatment costs were also calculated for all patients.ResultsThere were no significant differences in age, sex, ASA classification, preoperative course, or surgical time between the two groups (<i>p </i>> 0.05). The frail risk group had significantly higher mFI-5 and CCI scores (<i>p </i>< 0.05). This group also had a higher incidence of deep venous thrombosis and overall complications (<i>p </i>< 0.05), but similar rates of periprosthetic infection, hematoma, and anemia (<i>p </i>> 0.05). ROC analysis showed HFRS had the highest predictive value for postoperative complications (AUC = 0.851) compared to mFI-5 (0.786) and CCI (0.739). Surgical costs were similar (<i>p </i>> 0.05), but the frail group had longer hospital stays and higher total treatment costs (<i>p </i>< 0.05).ConclusionHFRS has better predictive value for perioperative complications in elderly patients undergoing artificial hip and knee arthroplasty compared to mFI-5 and CCI scores, and it can be used for predicting perioperative complications in elderly patients with this surgery.</p>","PeriodicalId":48978,"journal":{"name":"Technology and Health Care","volume":"33 3","pages":"1298-1303"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Technology and Health Care","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/09287329241296769","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/9 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundAlthough artificial hip and knee arthroplasty has been widely used, the incidence of perioperative complications remains relatively high due to factors such as long operation time and large surgical incisions. However, the Hospital Frailty Risk Score (HFRS) clinical value for patients undergoing artificial hip and knee arthroplasty in China is not yet clear. This study aims to explore its clinical value in this population.ObjectiveTo explore predictive value of the HFRS in perioperative complications of artificial hip and knee arthroplasty in elderly patients.MethodsElderly patients who underwent artificial hip and knee arthroplasty in our hospital from March 2020 to March 2022 were selected as the study subjects. The patients were divided into the non-frail risk group (HFRS <5 points) and the frail risk group (HFRS ≥5 points) on the basis of the literature grading method. 5-factor modified frailty index (mFI-5) and Charlson Comorbidity Index (CCI) scores were assessed. General data including age, sex, ASA classification, preoperative course, and surgical time were collected through the electronic medical record system. The occurrence of postoperative deep venous thrombosis, periprosthetic infection, hematoma, anemia, and overall complications was recorded. Hospitalization days, surgical costs, and total treatment costs were also calculated for all patients.ResultsThere were no significant differences in age, sex, ASA classification, preoperative course, or surgical time between the two groups (p > 0.05). The frail risk group had significantly higher mFI-5 and CCI scores (p < 0.05). This group also had a higher incidence of deep venous thrombosis and overall complications (p < 0.05), but similar rates of periprosthetic infection, hematoma, and anemia (p > 0.05). ROC analysis showed HFRS had the highest predictive value for postoperative complications (AUC = 0.851) compared to mFI-5 (0.786) and CCI (0.739). Surgical costs were similar (p > 0.05), but the frail group had longer hospital stays and higher total treatment costs (p < 0.05).ConclusionHFRS has better predictive value for perioperative complications in elderly patients undergoing artificial hip and knee arthroplasty compared to mFI-5 and CCI scores, and it can be used for predicting perioperative complications in elderly patients with this surgery.
背景人工髋关节置换术虽然应用广泛，但由于手术时间长、手术切口大等因素，围手术期并发症的发生率仍然较高。然而，医院衰弱风险评分（HFRS）在中国人工髋关节置换术患者中的临床价值尚不清楚。本研究旨在探讨其在该人群中的临床应用价值。目的探讨HFRS对老年人工髋关节置换术围手术期并发症的预测价值。方法选择2020年3月~ 2022年3月在我院行人工髋关节置换术的老年患者为研究对象。将患者分为非虚弱危险组（HFRS p < 0.05）。虚弱危险组的mFI-5和CCI评分显著高于对照组（p p p > 0.05）。ROC分析显示，与mFI-5（0.786）和CCI（0.739）相比，HFRS对术后并发症的预测价值最高（AUC = 0.851）。手术费用相似（p < 0.05），但虚弱组住院时间更长，总治疗费用更高（p < 0.05）
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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured. The main focus of THC is related to the overlapping areas of engineering and medicine. The following types of contributions are considered:
1.Original articles: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine. In particular, the clinical benefit deriving from the application of engineering methods and devices in clinical medicine should be demonstrated. Typically, full length original contributions have a length of 4000 words, thereby taking duly into account figures and tables.
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Reviews and Tutorials (upon invitation only): Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented. The Editorial Board is responsible for the selection of topics.
4.Minisymposia (upon invitation only): Under the leadership of a Special Editor, controversial or important issues relating to health care are highlighted and discussed by various authors.
5.Letters to the Editors: Discussions or short statements (not indexed).
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