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| 老年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 |
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| DOI：10.12089/jca.2022.06.010 |
| 中文关键词: 非心脏手术 老年 衰弱 术后并发症 |
| 英文关键词: Non-cardiac surgery Aged Frailty Postoperative complication |
| 基金项目:江苏省重点研发计划（社会发展）项目（BE2021749）；国家自然科学基金（82170503） |
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| 中文摘要: |
目的 分析非心脏手术老年患者术后并发症的危险因素。
方法 回顾性分析2021年3—8月行择期非心脏手术老年患者224例，男122例，女102例，年龄≥65岁，ASA Ⅰ—Ⅳ级。采用临床衰弱量表（CFS）评估患者术前衰弱状态。根据术后30 d是否发生并发症将患者分为两组：并发症组和非并发症组。采用单因素和多因素Logistic回归分析影响老年患者非心脏手术后并发症的危险因素。
结果 共有64例（28.6%）患者发生术后并发症。与非并发症组比较，并发症组年龄、查尔森共病指数（CCI）明显增大，ASA 分级明显增高，合并高血压、冠心病比例、衰弱比例、中性粒细胞浓度明显升高，白蛋白、Hb、淋巴细胞浓度明显降低, 出血量明显增多，手术时间和麻醉时间明显延长（P<0.05）。多因素Logistic回归分析结果显示，年龄增大（每增大1岁，OR=1.142，95%CI 1.064～1.225，P<0.05）和术前衰弱（OR=12.028，95%CI 3.727～38.816，P<0.05）是术后并发症的独立危险因素。
结论 年龄增大和术前衰弱是老年患者非心脏手术后并发症的独立危险因素。 |
| 英文摘要: |
Objective To investigate the risk factors of postoperative complications in elderly patients undergoing elective non-cardiac surgery.
Methods A total of 224 elderly patients undergoing elective non-cardiac surgery were analyzed retrospectively from March to August 2021, 122 males and 102 females, aged ≥ 65 years, ASA physical status Ⅰ-Ⅳ. Relevant perioperative data were collected and preoperative frailty status was assessed using clinical frailty scale (CFS). The patients were divided into two groups according to the occurrence of postoperative complications within 30 days: complications group and non-complication group. Univariate and multivariate logistic regression were used to investigate risk factors of postoperative complications.
Results Sixty-four patients (28.6%) had postoperative complications. Compared with the non-complication group, age, ASA physical status, Charlson comorbidity index (CCI), the incidence of hypertension, coronary heart disease and frailty, the proportion of neutrophils, blood loss, surgical time, and anesthesia time were significantly increased (P < 0.05); while the albumin, hemoglobin, and the proportion of lymphocyte were significantly decreased in the complication group (P < 0.05). As shown by multifactorial logistic regression analysis, aging (for every one year increased, OR = 1.142, 95% CI 1.064-1.225, P < 0.05) and preoperative frailty (OR = 12.028, 95% CI 3.727-38.816, P < 0.05) were independent risk factors of postoperative complications.
Conclusion Aging and preoperative frailty are independent risk factors for non-cardiac complications in elderly patients. |
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