目的 评价改良衰弱指数(mFI)在机器人辅助下老年肝切除术后并发症预测中的价值。方法 回顾性分析2021-01至2024-01解放军总医院第六医学中心收治的100例择期行机器人辅助下老年肝切除术患者的临床资料,根据mFI值将患者分为衰弱组(mFI≥0.27)和非衰弱组(mFI＜0.27)。对比两组患者围手术期的一般资料,探讨mFI评分与机器人辅助下老年肝切除术后并发症及术后转归的关系,通过受试者工作特征(ROC)曲线评估mFI评分在预测术后并发症方面的准确性。结果 本研究共纳入老年肝切除术患者90例,其中衰弱组42例,非衰弱组48例;两组患者年龄、美国麻醉医师协会(ASA)分级和总胆红素有统计学差异(P＜0.05);衰弱组住院时间、术后30 d内并发症发生率高于非衰弱组,差异有统计学意义(P＜0.05);多因素logistic回归分析显示,mFI是呼吸系统(OR=5.691;95%CI:0.842～0.985;P=0.001)、神经系统(OR=5.162;95%CI:0.836～0.968;P=0.001)、心血管系统(OR=7.548;95%CI:0.873～0.996;P=0.001)并发症的独立危险因素。结论 mFI在机器人辅助下老年肝切除术后并发症预测方面具有临床应用价值。
Abstract
Objective To evaluate the value of modified frailty index (mFI) in the prediction of complications after robot-assisted hepatectomy in elderly patients. Methods The clinical data of 100 elderly patients undergoing robot-assisted hepatectomy at the Sixth Medical Center of PLA General Hospital from January 2021 to January 2024 were retrospectively analyzed, and the patients were divided into the frailty group (mFI≥0.27) and the non-frailty group (mFI < 0.27) according to the mFI value. The general perioperative data of the two groups were compared to explore the relationship between mFI score and postoperative complications and postoperative outcomes in elderly patients after robot-assisted hepatectomy. The accuracy of mFI score in predicting postoperative complications was evaluated by receiver operating characteristics (ROC) curve. Results A total of 90 elderly patients undergoing hepatectomy were included in this study, including 42 patients in the frailty group and 48 patients in the non-frailty group. There were statistical differences in age, ASA grade and total bilirubin between the two groups(P<0.05). The length of hospital stay and the incidence of complications within 30 days after operation in frailty group were higher than those in non-frailty group with statistically significant differences (P<0.05). Multivariate Logistic regression analysis showed that mFI was the independent risk factor for the complications in respiratory system (OR=5.691; 95%CI: 0.842~0.985; P=0.001), nervous system (OR=5.162; 95%CI: 0.836~0.968; P=0.001), and cardiovascular system (OR=7.548; 95%CI: 0.873~0.996; P=0.001). Conclusions mFI has clinical application value in predicting postoperative complications in elderly patients with robot-assisted hepatectomy.
关键词
改良衰弱指数 /
机器人辅助肝切除术 /
老年 /
术后并发症
Key words
modified frailty index /
robot-assisted hepatectomy /
old age /
postoperative complication
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