弗里德表型在评估开颅肿瘤切除术患者术后效果中的预测力

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Sonora Andromeda Windermere, Kaitlyn Melnick, Sandra C Yan, Michelot Michel, Jonathan Munoz, Ghaidaa Ebrahim, Hayden Greene, Grace Hey, Muhammad Abdul Baker Chowdhury, Ashley P Ghiaseddin, Basma Mohammed, Maryam Rahman
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引用次数: 0

摘要

背景和目的:与反映患者合并症的改良虚弱指数-11(mFI-11)虚弱工具相比,弗里德表型更重视患者的功能性变量。本研究探讨了使用弗里德表型预测肿瘤患者开颅手术的术后结果:这项回顾性队列分析纳入了当前程序术语代码为颅内/颅外肿瘤切除术和术前虚弱评分的患者。病历审查收集了主要结果、住院时间(LOS)和次要结果、出院处置和术后并发症的其余变量。基本描述性统计总结了患者的人口统计学特征、临床参数和术后结果。χ2检验、t检验和方差分析检验了相关性和平均差异。逻辑回归和泊松回归探讨了预测因子与结果之间的关系:7年间,153名患者接受了Fried评估。Fried评分偏向于女性更虚弱(非虚弱38.0%为女性,虚弱前50.0%为女性,虚弱65.6%为女性,P = .027),但与年龄、体重指数或肿瘤类型无关。mFI-11 与年龄(非体弱者 67.8 岁 vs 体弱者 72.3 岁,P < .001)和体重指数(非体弱者 27.5 vs 体弱者 30.8,P < .001)有关,但与性别或肿瘤类型无关。Fried 评分与 LOS 的增加有明显相关性(几率比 [OR] = 5.92,95% CI = 1.66-21.13,P < .001),但 mFI-11 则没有相关性(OR = 0.82,95% CI = 0.35-1.93,P = .64)。弗里德表型与出院处置地点有明显相关性(P = .016),而 mFI-11 则没有相关性(P = .749)。Fried评分与术后并发症有明显相关性(OR = 1.36,95% CI = 1.08-1.71,P = .01),而mFI-11则没有相关性(OR = 1.10,95% CI = 0.86-1.41,P = .44):结论:与 mFI-11 评分相比,Fried 表型与术后结果(包括 LOS、出院处置地点和并发症)的相关性更准确。这些研究结果可用于指导术前规划、告知同意意见,并有可能确定哪些患者可能受益于术前的功能优化以改善术后效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive Power of the Fried Phenotype in Assessing Postoperative Outcomes in Patients Undergoing Craniotomy for Tumor Resection.

Background and objectives: Compared with the modified Frailty Index-11 (mFI-11) frailty tool, reflective of patient comorbidities, the Fried phenotype weighs functional patient variables. This study examined using the Fried phenotype in predicting postoperative outcomes in craniotomy for patients with tumor.

Methods: This retrospective cohort analysis included patients with Current Procedural Terminology codes for supratentorial/infratentorial tumor resections and preoperative frailty scores. Chart review collected the remaining variables for the primary outcome, length of stay (LOS), and secondary outcomes, discharge disposition and postoperative complications. Basic descriptive statistics summarized patient demographics, clinical parameters, and postoperative outcomes. χ2 tests, t-tests, and ANOVA examined associations and mean differences. Logistic and Poisson regressions explored predictor-outcome relationships.

Results: Over 7 years, these 153 patients underwent Fried assessments. The Fried score was biased toward females being more frail (nonfrail 38.0% female, prefrail 50.0% female and frail 65.6% female, P = .027) but not by age, body mass index, or tumor type. The mFI-11 was biased by age (nonfrail 67.8 years vs frail 72.3 years, P < .001) and body mass index (nonfrail 27.5 vs frail 30.8, P < .001) but not sex or tumor type. The Fried score was significantly correlated with increased LOS's (odds ratio [OR] = 5.92, 95% CI = 1.66-21.13, P < .001) but the mFI-11 was not (OR = 0.82, 95% CI = 0.35-1.93, P = .64). The Fried phenotype was significantly correlated with discharge disposition location (P = .016), whereas the mFI-11 was not (P = .749). The Fried score was significantly correlated with postoperative complications (OR = 1.36, 95% CI = 1.08-1.71, P = .01), whereas the mFI-11 was not (OR = 1.10, 95% CI = 0.86-1.41, P = .44).

Conclusion: The Fried phenotype more accurately correlates with postoperative outcomes including LOS, discharge disposition location, and complications than does the mFI-11 score. These findings can be used to guide preoperative planning, inform consent, and potentially identify patients who may benefit from functional optimization in the preoperative period to improve postoperative outcomes.

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来源期刊
Neurosurgery
Neurosurgery 医学-临床神经学
CiteScore
8.20
自引率
6.20%
发文量
898
审稿时长
2-4 weeks
期刊介绍: Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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