Modified frailty index predicts early outcomes after colorectal surgery : an ACS-NSQIP study
Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland..
AIM: Frailty is defined as a decrease in physiological reserve with increased risk of morbidity following significant physiological stressors. This study examines the predictive power of the five-item modified frailty index (5-mFI) in predicting outcomes in colorectal surgery patients.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program Database was queried from 2011 to 2016 to determine the predictive power of 5-mFI in patients who had colorectal surgery.
RESULTS: Of 295 490 patients, 45.8% had a score of 0, 36.2% had a score of 1 and 18% had a score of ≥ 2. On univariate analysis, frailer patients had significantly greater incidences for overall morbidity, serious morbidity, mortality, prolonged length of hospital stay, discharge to a facility other than home, reoperation and unplanned readmission. These findings were consistent on multivariate analysis where the frailest patients had greater odds of postoperative overall morbidity (OR 1.39; 95% CI 1.35-1.43), serious morbidity (OR 1.39; 95% CI 1.33-1.45), mortality (OR 2.00; 95% CI 1.87-2.14), prolonged length of hospital stay (OR 1.24; 95% CI 1.20-1.27), discharge destination to a facility other than home (OR 2.80; 95% CI 2.70-2.90), reoperation (OR 1.17; 95% CI 1.11-1.23) and unplanned readmission (OR 1.31; 95% CI 1.26-1.36). Weighted kappa statistics showed strong agreement between the 5-mFI and 11-mFI (kappa = 0.987, P < 0.001).
CONCLUSIONS: The 5-mFI is a valid and easy to use predictor of 30-day postoperative outcomes after colorectal surgery. This tool may guide the surgeon to proactively recognize frail patients to instigate interventions to optimize them preoperatively.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland - 21(2019), 10 vom: 01. Okt., Seite 1192-1205 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Al-Khamis, A [VerfasserIn] |
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| Links: |
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| Themen: |
Colorectal |
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| Anmerkungen: |
Date Completed 04.11.2020 Date Revised 04.11.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/codi.14725 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM297803344 |
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| 100 | 1 | |a Al-Khamis, A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modified frailty index predicts early outcomes after colorectal surgery |b an ACS-NSQIP study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland. | ||
| 520 | |a AIM: Frailty is defined as a decrease in physiological reserve with increased risk of morbidity following significant physiological stressors. This study examines the predictive power of the five-item modified frailty index (5-mFI) in predicting outcomes in colorectal surgery patients | ||
| 520 | |a METHODS: The American College of Surgeons National Surgical Quality Improvement Program Database was queried from 2011 to 2016 to determine the predictive power of 5-mFI in patients who had colorectal surgery | ||
| 520 | |a RESULTS: Of 295 490 patients, 45.8% had a score of 0, 36.2% had a score of 1 and 18% had a score of ≥ 2. On univariate analysis, frailer patients had significantly greater incidences for overall morbidity, serious morbidity, mortality, prolonged length of hospital stay, discharge to a facility other than home, reoperation and unplanned readmission. These findings were consistent on multivariate analysis where the frailest patients had greater odds of postoperative overall morbidity (OR 1.39; 95% CI 1.35-1.43), serious morbidity (OR 1.39; 95% CI 1.33-1.45), mortality (OR 2.00; 95% CI 1.87-2.14), prolonged length of hospital stay (OR 1.24; 95% CI 1.20-1.27), discharge destination to a facility other than home (OR 2.80; 95% CI 2.70-2.90), reoperation (OR 1.17; 95% CI 1.11-1.23) and unplanned readmission (OR 1.31; 95% CI 1.26-1.36). Weighted kappa statistics showed strong agreement between the 5-mFI and 11-mFI (kappa = 0.987, P < 0.001) | ||
| 520 | |a CONCLUSIONS: The 5-mFI is a valid and easy to use predictor of 30-day postoperative outcomes after colorectal surgery. This tool may guide the surgeon to proactively recognize frail patients to instigate interventions to optimize them preoperatively | ||
| 650 | 4 | |a Evaluation Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Frailty | |
| 650 | 4 | |a NSQIP | |
| 650 | 4 | |a colorectal | |
| 650 | 4 | |a outcomes | |
| 650 | 4 | |a postoperative | |
| 700 | 1 | |a Warner, C |e verfasserin |4 aut | |
| 700 | 1 | |a Park, J |e verfasserin |4 aut | |
| 700 | 1 | |a Marecik, S |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, N |e verfasserin |4 aut | |
| 700 | 1 | |a Mellgren, A |e verfasserin |4 aut | |
| 700 | 1 | |a Nordenstam, J |e verfasserin |4 aut | |
| 700 | 1 | |a Kochar, K |e verfasserin |4 aut | |
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