老年结直肠癌患者术前衰弱与术后并发症的相关性  

Correlation between preoperative frailty and postoperative complications in elderly patients with colorectal cancer

作　　者：陈思芮 陈海林 杨雪梅 梁湘 陈英[2] Chen Sirui;Chen Hailin;Yang Xuemei;Liang Xiang;Chen Ying(Colorectal and Anal Department,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China;Nursing Department,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院结直肠肛门科,南宁530021 [2]广西医科大学附属肿瘤医院护理部,南宁530021

出　　处：《中华老年多器官疾病杂志》2023年第2期119-123,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2018109)。

摘　　要：目的探讨老年结直肠癌根治术患者术前衰弱与术后并发症的相关性。方法选取2021年5月至8月广西医科大学附属肿瘤医院147例择期行腹腔镜结直肠癌根治术的老年患者为研究对象,采用一般资料调查表、美国医师麻醉协会(ASA)分级标准、蒂尔堡衰弱指数量表,调查患者衰弱和分级情况,同时记录患者并发症发生情况。采用SPSS 26.0统计软件进行数据分析。根据数据类型,组间比较采用χ^(2)检验。采用二元logistic回归分析老年结直肠癌根治术患者术后并发症发生的危险因素。采用Spearman秩相关分析术前衰弱与术后并发症的相关性。构建受试者工作特征(ROC)曲线评价术前衰弱评估、ASA分级及联合应用对术后并发症的预测价值。结果logistic回归分析结果显示,日常生活能力量表(ADL)得分、衰弱得分、ASA分级是患者术后并发症发生的影响因素。Speaman相关分析结果显示,术前衰弱与术后并发症呈正相关(r=0.427)。衰弱评估联合ASA分级ROC曲线下面积大于单独使用衰弱评估或ASA分级,曲线下面积(AUC)分别为0.797、0.740与0.697,联合应用的灵敏度和特异度分别为92.3%和51.9%。结论术前衰弱是术后并发症发生的独立危险因素及预测因子,术前衰弱评估联合ASA分级能提高对术后并发症发生的预测能力,为患者围手术期安全管理提供依据。Objective To explore the correlation between preoperative frailty and postoperative complications in the elderly colorectal cancer patients undergoing radical surgery.Methods A total of 147 elderly patients who underwent elective laparoscopic radical surgery for colorectal cancer in the Affiliated Tumor Hospital of Guangxi Medical University from May to August 2021 were selected as the research subjects.The general data questionnaire,the grading standard of the American Society of Aneshesiologists(ASA)and the Tilburg frailty index(TFI)were used to investigate the patients′frailty and grading.At the same time,the patients′complications were recorded.Data analysis was performed using SPSS statistics 26.0.According to the data type,χ^(2)test was used for comparison between groups.Binary logistic regression was used to analyze the risk factors of complications,and Spearman rank correlation was used to analyze the correlation between preoperative frailty and postoperative complications.Receiver operating characteristic(ROC)curve was used to evaluate the predictive performance of preoperative frailty assessment,predictive value of ASA classification and combined application on postoperative complications.Results Logistic regression analysis showed that activity of daily living(ADL)score,frailty score,and ASA grade were the influencing factors of postoperative complications.Spearman correlation analysis showed that preoperative frailty was positively correlated with postoperative complications(r=0.427).The area under ROC curve of frailty assessment combined with ASA classification is larger than that of frailty assessment alone or ASA classification(AUC=0.797,0.740,0.697).The sensitivity and specificity of joint application were 92.3%and 51.9%,respectively.Conclusion Preoperative frailty is an independent risk factor and predictor of postoperative complications,and preoperative frailty assessment combined with ASA classification can enhance the predictive ability of postoperative complications,providing basis for t

关 键 词：老年人 结直肠癌 衰弱 ASA分级 术后并发症 

分 类 号：R735.3[医药卫生—肿瘤]