5因子改良衰弱指数与感染性腹主动脉瘤病人预后关联研究  

Study on association between the 5-factor modified frailty index and prognosis in patients with infectious abdominal aortic aneurysm

作　　者：王鼎 戴先鹏 李潭[2] 王雷[1] 李璇[1] 姜波[1] 荆玉辰[1] 吴式 赵成东 辛世杰[1] WANG Ding;DAI Xian-peng;LI Tan(Department of Vascular Surgery,the First Hospital of China Medical University,Regenerative Medicine Research Center,China Medical University,Key Laboratory of Etiology and Prevention of Arterial Diseases of Liaoning Province,Shenyang 110001,China;不详)

机构地区：[1]中国医科大学附属第一医院中国医科大学再生医学研究中心辽宁省动脉瘤疾病病因及防治研究重点实验室血管外科,辽宁沈阳110001 [2]中国医科大学附属第一医院中国医科大学再生医学研究中心辽宁省动脉瘤疾病病因及防治研究重点实验室超声科,辽宁沈阳110001

出　　处：《中国实用外科杂志》2024年第12期1389-1392,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.81974049);辽宁省科学技术计划项目(No.2023JH2/101700088,No.2022JH1/10400002)。

摘　　要：目的 评估5因子改良衰弱指数(mFI-5)与感染性腹主动脉瘤病人的关联,以期帮助临床进行更好决策和预后评估。方法 回顾性分析2011年3月至2022年11月于中国医科大学附属第一医院血管外科就诊的100例感染性腹主动脉瘤病人的临床资料,将符合纳排标准的手术治疗病人纳入研究。根据mFI-5评分将病人分为mFI-5=0、mFI-5=1及mFI-5≥2 3组,并比较3组间基线资料、术后主要结局和次要结局的差异。结果 各组间在年龄段、吸烟史及手术方案等基线特点方面差异无统计学意义(P>0.05)。3组间感染性腹主动脉瘤相关再次介入手术、急性肾衰、因出血所致输血、脑出血、消化道出血、下肢动脉血栓形成、脓毒血症等的发生率均差异无统计学意义(P>0.05)。mFI-5评分≥2分的感染性腹主动脉瘤病人1年和5年的全因死亡率、IAAA相关死亡率、术后心肌梗死、术后呼吸机使用≥48 h的发生率相较与其余两组明显升高,差异有统计学意义(P<0.05)。结论mFI-5评分与全因及IAAA相关死亡率、术后心肌梗死、术后呼吸机使用≥48 h的发生率相关,该工具可能成为虚弱的感染性腹主动脉瘤病人拟行手术治疗的有效筛查工具。Objective To evaluate the impact of the 5-factor modified frailty index(mFI-5) on the prognosis of patients with infectious abdominal aortic aneurysm,aiming to assist in clinical decision-making and prognostic assessment.Methods The clinical data of 100 patients with infected abdominal aortic aneurysm at the Department of Vascular Surgery,the First Affiliated Hospital of China Medical University from March 2011 to November 2022 were retrospectively analyzed,and the patients who met the inclusion and exclusion criteria were included in the study.They were divided into three groups according to the m FI-5 score(m FI-5=0,m FI-5=1,mFI-5≥2),and the differences in baseline data,primary outcomes,and secondary outcomes among the three groups were compared.Results There were no statistically significant differences in baseline characteristics such as age range,smoking history,and surgical plan among the groups(P>0.05).There were no statistically significant differences among the three groups in the incidence of infectious abdominal aortic aneurysm-related reintervention,acute renal failure,blood transfusion for bleeding,cerebral hemorrhage,gastrointestinal hemorrhage,lower extremity arterial thrombosis,and sepsis.The 1-year and 5-year allcause mortality,IAAA-related mortality,postoperative myocardial infarction,and postoperative ventilator use ≥48 hours were significantly higher in patients with infected abdominal aortic aneurysm with mFI-5 score ≥2 than those in the other two groups,and the difference was statistically significant(P<0.05).Conclusion The mFI-5 score is associated with all-cause and IAAA-related mortality,postoperative myocardial infarction,and postoperative ventilator use for ≥48 hours.The mFI-5 score may be a usefulscreening tool for the surgical treatment of frailpatients with infected abdominal aorticaneurysms.

关 键 词：感染性腹主动脉瘤 虚弱 5因子改良衰弱指数 预后结局 

分 类 号：R6[医药卫生—外科学]