基于术前aCCI与mFI的结直肠癌患者术后并发症风险评估  

Risk assessment of postoperative complications in colorectal cancer patients based on preoperative aCCI index and mFI

作　　者：刘少博 刘大勇 郭强 LIU Shao-bo(Department of Gastroenterology,Zhumadian Central Hospital,Zhumadian 463000,Henan,China)

机构地区：[1]驻马店市中心医院胃肠外科,河南驻马店463000

出　　处：《牡丹江医科大学学报》2025年第2期67-71,共5页Journal of Mudanjiang Medical University

基　　金：黑龙江省青年科学基金项目(QC2009C45);黑龙江省大学生创新创(201310229026);牡丹江医学院大学生科研项目。

摘　　要：目的分析术前年龄校准的查尔森共病指数(age-adjusted charlson comorbidity index,aCCI)和改良衰弱指数(modified frailty index,mFI)预测结直肠癌患者术后并发症的临床价值。方法选取2022年01月至2025年01月于本院行手术治疗的结直肠癌患者230例,术后随访28 d统计并发症发生情况,将发生并发症的患者纳入发生组,未发生患者纳入未发生组。比较未发生组、发生组aCCI、mFI及一般资料;采用Logistic回归模型分析结直肠癌患者术后并发症的影响因素;用受试者工作特征曲线(ROC)分析aCCI、mFI单独及联合预测结直肠癌患者术后并发症的效能。结果术后并发症发生率13.43%;发生组aCCI及mFI 0.36、0.45构成比高于未发生组(P<0.05),mFI 0构成比低于未发生组(P<0.05);Logistic回归模型分析显示,糖尿病、美国麻醉师协会(ASA)分级Ⅲ级、手术时间、aCCI、mFI>0.27是结直肠癌患者术后并发症的影响因素(P<0.05);aCCI、mFI联合预测结直肠癌患者术后并发症的灵敏度及曲线下面积(AUC)均高于单独预测,特异度与单独预测基本一致。结论术前aCCI联合mFI可有效预测结直肠癌患者术后并发症发生风险。Objective To analyze the clinical value of preoperative age-adjusted Charlson comorbidity index(aCCI)and modified frailty index(mFI)in predicting postoperative complications in colorectal cancer patients.Methods A retrospective analysis was conducted on 230 patients who underwent surgical treatment for colorectal cancer at our hospital from January 2022 to January 2025.Postoperative complications were recorded over a 28-day follow-up period.Patients were divided into two groups:those who developed complications(occurrence group)and those who did not(non-occurrence group).The aCCI,mFI and general data were compared between the two groups.Logistic regression model was used to identify risk factors for postoperative complications in colorectal cancer patients.The predictive efficacy of aCCI and mFI,both individually and in combination,was assessed using receiver operating characteristic(ROC)curve analysis.Results The overall incidence of postoperative complications was 13.43%.The occurrence group exhibited higher proportions of aCCI and mFI values of 0.36 and 0.45 compared to the non-occurrence group(P<0.05),while the proportion of mFI was lower than that in the non-occurrence group(P<0.05).Logistic regression model analysis showed that diabetes,ASA grade III,operation time,aCCI,mFI>0.27 were the risk factors for postoperative complications in colorectal cancer patients(P<0.05).The sensitivity and area under the curve(AUC)of aCCI and mFI combined in predicting postoperative complications in colorectal cancer patients were higher than those of single prediction,with specificity remaining consistent with single-predictor models.Conclusion Preoperative aCCI combined with mFI can effectively predict the risk of postoperative complications in colorectal cancer patients.

关 键 词：结直肠癌 并发症 年龄校准的查尔森共病指数 改良衰弱指数 

分 类 号：R735.3[医药卫生—肿瘤]