摘要
目的比较衰弱老年患者和非衰弱老年患者非心脏大手术术后30d生活质量的差别。方法选取2019年1月-6月在复旦大学附属华东医院择期行非心脏大手术的老年患者,术前1 d采用埃德蒙顿衰弱评估量表(Edmonton Frail Scale,EFS)评估衰弱程度,将患者分为衰弱组和非衰弱组。采用世界卫生组织残疾评定量表(World Health Organization Disability Assessment Schedule,WHODAS)评估术前、术后30 d的生活质量。记录术后入ICU率、术后30 d内并发症发生率、全因死亡率、总住院时间、术后住院时间和住院费用。结果共纳入189例患者。其中,衰弱老年患者24例,非衰弱老年患者165例。衰弱组术后-术前WHODAS得分[11.5 (8.3~14.8)]高于非衰弱组[3.0 (1.0~5.0),P<0.01]。衰弱组术后30d内肺部并发症发生率、全因死亡率较高,住院时间和住院费用增加(P<0.05)。按年龄和手术类型对2组患者进行1:1倾向性评分匹配后,衰弱组术后-术前WHODAS得分仍高于非衰弱组(P<0.01)。结论衰弱老年患者行非心脏大手术后30 d生活质量下降程度较非衰弱老年患者更显著,且术后不良事件及住院时间、住院费用增加,提示临床上应更加关注衰弱老年患者术后生活质量的恢复。
Objective To compare the difference in quality of life between frail elderly patients and non-frail elderly patients 30 days after non-cardiac major surgery.Methods Elderly patients who underwent elective non-cardiac major surgery in the Huadong Hospital Affiliated to Fudan University from January to June 2019 were selected.One day before the operation,the Edmonton Frail Scale(EFS) was used to assess the degree of frailty,and then patients were divided into frail group and non-frail group.The World Health Organization Disability Assessment Schedule(WHODAS) was used to assess the quality of life before and 30 days after the surgery.The rate of admission to ICU,the incidence of complications within 30 days,allcause mortality,total hospitalization time,postoperative hospitalization time and hospitalization expenses were recorded and compared between the two groups.Results A total of 189 patients were enrolled,including 24 frail ones and 165 non-frail ones.The postoperative WHODAS score-preoperative WHODAS score(post-pre WHODAS score) of the frail group [11.5(8.3~14.8)] was larger than that of the non-frail group [3.0(1.0~5.0),P<0.01].Compared with the non-frail group,the frail group had a higher incidence of pulmonary complications within 30 days after the operation and all-cause mortality,and the hospitalization time and hospitalization expenses increased(P<0.05).After matching the two groups of patients with a 1:1 propensity score according to age and type of the surgery,the post-pre WHODAS score of the frail group was still higher than that of the non-frail group(P<0.01).Conclusion The decline of the quality of life of frail elderly patients within30 days after non-cardiac major surgery is more significant than that of non-frail elderly patients,and their postoperative adverse events,hospitalization time,and hospitalization expenses increase,which suggesting that the quality of life of frail elderly patients after non-cardiac surgery need to be paid special attention.
作者
朱蕊
顾卫东
张细学
Zhu Rui;Gu Weidong;Zhang Xixue(Department of Anesthesiology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2021年第5期1050-1055,共6页
Geriatrics & Health Care
基金
上海市临床重点专科建设项目(shslczdzk02801)。
关键词
老年
衰弱
围术期
生活质量评估
elderly
frailty
perioperative period
quality of life assessment