摘要
目的评估术前衰弱对老年食管癌患者术后并发症的影响。方法回顾性分析上海市胸科医院2021年经外科手术治疗的食管癌患者(年龄≥65岁)的临床资料。计算改良衰弱指数(the modified frailty index,mFI),将患者分为无衰弱组和衰弱组。主要研究指标是术后肺部感染、心律失常、吻合口瘘、乳糜胸并发症发生率。次要研究指标包括术后拔出气管导管时间、非计划性再插管率、ICU停留时间、总住院时间、出院30 d内再入院率和术后30 d内死亡率。结果纳入607例患者,其中衰弱组334例、无衰弱组273例。无衰弱组患者术后肺部感染(5.5%vs.13.5%)、心律失常(3.7%vs.9.3%)、吻合口瘘(2.9%vs.7.5%)并发症发生率低于衰弱组(P<0.05)。无衰弱组患者ICU停留时间[2.0(0.0,4.0)d vs.4.0(1.0,6.0)d]、总住院时间[11.5(9.5,13.0)d vs.13.0(11.0,18.0)d]、30 d内再入院率(2.9%vs.6.6%)和30 d内死亡率(0.4%vs.1.2%)短于或低于衰弱组(P<0.05)。结论术前衰弱的老年食管癌患者手术后并发症发生率高。mFI可以作为识别老年食管癌高危患者的客观指标。
Objective To evaluate the effect of frailty on postoperative complications in elderly patients with esophageal cancer.Methods We enrolled the patients aged≥65 years and with esophageal cancer who underwent surgical treatment in Shanghai Chest Hospital in 2021.The modified frailty index(mFI)was calculated and the patients were divided into a non-frailty group and a frailty group.The primary outcomes were the incidence of postoperative pulmonary infection,arrhythmia,anastomotic fistula and chylothorax complications.Secondary outcomes were the time of extubation,the rate of unplanned re-intubation,the length of ICU stay,hospital stay,rate of readmission within 30 days after discharge and the mortality within 30 days after operation.Results Finally 607 patients were collected.There were273 patients in the non-frailty group and 334 patients in the frailty group.The non-frailty group had lower rates of complications including pulmonary infection(5.5%vs.13.5%),arrhythmia(3.7%vs.9.3%),anastomotic fistula(2.9%vs.7.5%),and shorter ICU stay[2.0(0.0,4.0)d vs.4.0(1.0,6.0)d]and in-hospital stay[11.5(9.5,13.0)d vs.13.0(11.0,18.0)d],lower rates of the readmission within 30 days(2.9%vs.6.6%)and the mortality within 30 days(0.4%vs.1.2%)compared with the frailty group(P<0.05).Conclusion Frail elderly patients with esophageal cancer have higher rates of postoperative complications.mFI can be used as an objective index to identify high-risk elderly patients with esophageal cancer.
作者
郭嘉琪
吴镜湘
姚海霞
李斌
苗青
GUO Jiaqi;WU Jingxiang;YAO Haixia;LI Bin;MIAO Qing(Department of Anesthesiology,Shanghai Chest Hospital,Chest Hospital Affiliated to Medical College of Shanghai Jiao Tong University,Shanghai,200030,P.R.China;Department of Thoracic Surgery,Shanghai Chest Hospital,Chest Hospital Affiliated to Medical College of Shanghai Jiao Tong University,Shanghai,200030,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2023年第8期1169-1174,共6页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
上海交通大学“科技创新专项资金”青年项目(YG2021QN124)。
关键词
衰弱
老年患者
食管癌
并发症
Frailty
elderly patients
esophageal cancer
complications
