Predictive value of 5-Factor modified frailty index in Oncologic and benign hysterectomies.
Predictive value of 5-Factor modified frailty index in Oncologic and benign hysterectomies.
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DOI：
10.1016/j.gore.2022.101063
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发表时间：
2022-10
影响因子：
1.2
通讯作者：
Ko, Emily M.
中科院分区：
文献类型：
--
作者：
Hermann, Catherine E.;Koelper, Nathanael C.;Andriani, Leslie;Latif, Nawar A.;Ko, Emily M.
mFI-5 是一种易于使用的虚弱指数，由五个现成的健康因素组成。 mFI-5 可以强烈预测良性和肿瘤人群子宫切除术后 30 天内的死亡率。 mFI-5 预测良性和肿瘤人群术后发病率和再入院的能力有所不同。 mFI-5可以简化高危患者的识别，为术前康复提供机会。 5 因素修正衰弱指数 (mFI-5) 已在妇科手术中针对原始 11 因素修正衰弱指数进行了验证，但尚未在良性与妇科肿瘤患者群体之间评估其实用性。评估 mFI-5 在识别良性和肿瘤适应症子宫切除术后 30 天内主要术后并发症、再入院或死亡风险增加的女性方面的预测价值。从 NSQIP 数据库中识别出 2015 年至 2017 年间接受子宫切除术的患者，并将其分为良性或恶性适应症。提取了人口统计和 mFI-5 变量。 mFI-5 的计算方法是将所有肯定变量的总和除以数据库中输入变量的总数。进行逻辑回归模型调整混杂因素。回归后获得 95% CI 的 C 统计量。确定了 80,293 例子宫切除术（59,078 例为良性子宫切除术，21,215 例为肿瘤性子宫切除术）。良性组的 mFI-5 评分更有可能为 0（70% vs 50%，p = 0.001），并且手术时间更短（p = 0.001）。在良性组中，mFI-5 是死亡率的强预测因子（c = 0.819，CI 0.704–0.933）。在肿瘤学组中，mFI-5 是死亡率的强有力预测因子（c = 0.801，CI 0.750–0.851），特别是对于子宫癌和宫颈癌。它对再入院具有中等预测性（c = 0.671，CI 0.656–0.686），对 Clavien-Dindo III 级和 IV 级并发症有较强预测性（c = 0.732，CI 0.713–0.750）。 mFI-5 是 30 天死亡率和严重术后并发症的有力预测因子。这些发现有可能改善术前高危患者的识别。
The mFI-5 is an easy-to-use frailty index consisting of five readily-available health factors. The mFI-5 is strongly predictive of mortality within 30 days of hysterectomy in both benign and oncologic populations. The ability of the mFI-5 to predict postoperative morbidity and readmission varies between benign and oncologic populations. The mFI-5 can simplify identification of high-risk patients, providing an opportunity for preoperative rehabilitation. The 5-factor modified frailty index (mFI-5) has been validated against the original 11-factor modified frailty index in gynecologic surgery, however its utility has not been evaluated between benign versus gynecologic oncology patient populations. To evaluate the predictive value of the mFI-5 in identifying women at increased risk for major postoperative complications, readmission, or death within 30 days of hysterectomy for benign and oncologic indications. Patients who underwent hysterectomy between 2015 and 2017 were identified from the NSQIP database and stratified into benign or malignant indications. Demographic and mFI-5 variables were extracted. The mFI-5 was calculated by dividing the sum of all affirmative variables by the total number of input variables in the database. Logistic regression modeling was performed adjusting for confounders. C-statistic with 95% CI was obtained post-regression. 80,293 hysterectomies (59,078 benign and 21,215 oncologic) were identified. The benign group was more likely to have an mFI-5 score of 0 (70 % vs 50 %, p = 0.001) and had shorter operative times (p = 0.001). In the benign group, mFI-5 was a strong predictor of mortality (c = 0.819, CI 0.704–0.933). Within the oncology group, the mFI-5 was a strong predictor of mortality (c = 0.801, CI 0.750–0.851), particularly for uterine and cervical cancers. It was moderately predictive of readmission (c = 0.671, CI 0.656–0.686) and strongly predictive of Clavien-Dindo class III and IV complications (c = 0.732, CI 0.713–0.750). The mFI-5 is a strong predictor of 30-day mortality and serious postoperative complications. These findings have the potential to improve identification of high-risk patients in the preoperative setting.
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DOI：
10.1016/j.jamcollsurg.2017.11.005
发表时间：
2018-02-01
影响因子：
5.2
作者：
Subramaniam, Sneha;Aalberg, Jeffrey J.;Divino, Celia M.
通讯作者：
Divino, Celia M.
影响因子：
4
作者：
Orlandini, Laura;Nestola, Tiziano;Cesari, Matteo
通讯作者：
Cesari, Matteo
影响因子：
3.8
作者：
Wainger, Julia J.;Yazdy, Golsa M.;Handa, Victoria L.
通讯作者：
Handa, Victoria L.
影响因子：
4.7
作者：
Mullen, Mary M.;Porcelli, Bree P.;Thaker, Premal H.
通讯作者：
Thaker, Premal H.
影响因子：
4.7
作者：
Uppal, Shitanshu;Igwe, Elena;Rose, Stephen L.
通讯作者：
Rose, Stephen L.