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J Am Coll Surg. 2015;221(3):652-60.e2.

Prediction of Postoperative Complications Using Multidimensional Frailty Score in Older Female Cancer Patients with American Society of Anesthesiologists Physical Status Class 1 or 2.

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제1저자 최정연 · 교신저자 김광일

소속 (6)
  1. Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea.
  2. Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  3. Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: kikim907@snu.ac.kr.
  4. Department of Surgery, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  5. Department of Surgery, Breast Care Center, Daerim St. Mary's Hospital, Seoul, Republic of Korea.
  6. Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Abstract

BACKGROUND Even low-risk, elderly patients are at increased risk for postoperative morbidity compared with their younger counterparts. We sought to evaluate the role of a scoring model in predicting adverse surgical outcomes in low-risk, older, female cancer patients.

STUDY DESIGN From October 2011 to May 2014, two hundred and eighty-one low-risk female patients (aged 65 years and older, American Society of Anesthesiologists class 1 or 2) undergoing curative cancer surgery were included. The Multidimensional Frailty Score (MFS) was calculated by comprehensive geriatric assessment. The primary end point was postoperative complication (eg, pneumonia, urinary tract infection, delirium, acute pulmonary thromboembolism, and unplanned ICU admission). Secondary outcomes were length of hospital stay and institutionalization.

RESULTS Twenty patients experienced postoperative complications and 15 patients were discharged to nursing facilities. The fully adjusted odds ratio (OR) per 1-point increase in MFS was 1.412 (95% CI, 1.012-1.969; p = 0.042) for postoperative complications, 1.377 (95% CI, 0.935-2.026; p = 0.105) for institutionalization, and 1.411 (95% CI, 1.110-1.793; p = 0.005) for prolonged hospital stay. The high-risk group (MFS ≥7) showed an increased risk for postoperative complications (OR = 8.513; 95% CI, 2.210-32.785; p = 0.002), institutionalization (OR = 1.291; 95% CI, 0.324-5.152; p = 0.717), and prolonged hospital stay (OR = 2.336; 95% CI, 1.090-5.006; p = 0.029) compared with the low-risk group (MFS <7), after adjusting confounders.

CONCLUSIONS Multidimensional Frailty Score based on a preoperative comprehensive geriatric assessment is useful for predicting postoperative complications and prolonged hospital stay, even in low-risk elderly women who are undergoing cancer surgery.

Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

그 밖의 정보
출판 형태
Journal Article
저널
Journal of the American College of Surgeons · eISSN 1879-1190
전자 출판
2015-06-20
MeSH
Aged · Elective Surgical Procedures / statistics & numerical data · Female · Frail Elderly / statistics & numerical data · Geriatric Assessment* · Health Status Indicators* · Humans · Neoplasms / surgery · Postoperative Complications / epidemiology · Prognosis · Retrospective Studies · Risk Assessment