Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

作者全名：Xiong, Xianwei; Zhang, Ting; Chen, Huan; Jiang, Yiling; He, Shuangyu; Qian, Kun; Li, Hui; Guo, Xiong; Jin, Juying

作者地址：[Xiong, Xianwei; Zhang, Ting; Chen, Huan; Jiang, Yiling; He, Shuangyu; Jin, Juying] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Qian, Kun; Li, Hui; Guo, Xiong] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China

通信作者：Jin, JY (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, 1 Youyi Rd, Chongqing 400016, Peoples R China.

来源：BMC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001204514000003

JCR分区：Q2

影响因子：1.6

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Prolonged postoperative ileus; Frailty; Elderly patients; Prediction; Major abdominal surgery

摘要：Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI.Methods Patients (aged >= 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected.Results The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572-6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577-0.730] and GFI (OR 2.627, 95% CI 1.307-5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery.Conclusions Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI.Trial registration This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/.

基金机构：Foundation of Chongqing Municipal Public Health Bureau, Chongqing People's Municipal Government

基金资助正文：We thank all subjects, investigators and hospital staff involved in our study.