New 5-Factor Modified Frailty Index Using American College of Surgeons NSQIP Data
New 5-Factor Modified Frailty Index Using American College of Surgeons NSQIP Data
复制标题
DOI：
10.1016/j.jamcollsurg.2017.11.005
复制
发表时间：
2018-02-01
影响因子：
5.2
通讯作者：
Divino, Celia M.
中科院分区：
文献类型：
--
作者：
Subramaniam, Sneha;Aalberg, Jeffrey J.;Divino, Celia M.
背景技术背景：改良虚弱指数（mFI-11）是一种基于NSQIP的11因素指数，已被证明可以充分反映虚弱程度并预测死亡率和发病率。这11个因素，由16个变量组成，映射到原始的70项加拿大健康和衰老脆弱指数研究。在过去的几年中，某些NSQIP变量已从数据库中删除;截至2015年，原始11个因素中只有5个保留下来。在过去的文献中，这5个因素在指数（mFI-5）中的预测能力和有用性尚未得到证明。我们的研究的目的是比较的MFI-5的MFI-11的价值和预测能力的死亡率，术后感染，和计划外30天reincipitation.Study设计：的MFI计算除以现有的因素为患者的数量，可用的因素，没有缺失的数据。使用斯皮尔曼rho评估mFI-5和mFI-11之间的相关性。预测模型，使用未经调整和调整的逻辑回归，创建每个结果为9个外科亚专业使用2012年NSQIP数据，去年所有的MFI-11 variables existing.RESULTS：之间的相关性MFI-5和MFI-11在所有外科专业，除了心脏和血管手术是0.9以上。调整和未调整的模型显示了类似的c-统计的MFI-5和MFI-11，和死亡率和术后并发症的预测能力强CONCLUSIONS. The MFI-5和MFI-11是同样有效的预测在所有的亚专业和MFI-5是一个强大的预测死亡率和术后并发症。它具有可信度，为今后使用的NSQIP数据库内的脆弱性研究。它在其他数据库和临床应用中也有潜力。((C)2017由Elsevier Inc.出版美国外科医生学会（American College of Surgeons）
BACKGROUND: The modified frailty index (mFI-11) is a NSQIP-based 11-factor index that has been proven to adequately reflect frailty and predict mortality and morbidity. These 11 factors, made of 16 variables, map to the original 70-item Canada Study of Health and Aging Frailty Index. In past years, certain NSQIP variables have been removed from the database; as of 2015, only 5 of the original 11 factors remained. The predictive power and usefulness of these 5 factors in an index (mFI-5) have not been proven in past literature. The goal of our study was to compare the mFI-5 to the mFI-11 in terms of value and predictive ability for mortality, postoperative infection, and unplanned 30-day readmission.STUDY DESIGN: The mFI was calculated by dividing the number of factors present for a patient by the number of available factors for which there were no missing data. Spearman's rho was used to assess correlation between the mFI-5 and mFI-11. Predictive models, using both unadjusted and adjusted logistic regressions, were created for each outcome for 9 surgical sub-specialties using 2012 NSQIP data, the last year all mFI-11 variables existed.RESULTS: Correlation between the mFI-5 and mFI-11 was above 0.9 across all surgical specialties except for cardiac and vascular surgery. Adjusted and unadjusted models showed similar c-statistics for mFI-5 and mFI-11, and strong predictive ability for mortality and postoperative complications.CONCLUSIONS: The mFI-5 and the mFI-11 are equally effective predictors in all sub-specialties and the mFI-5 is a strong predictor of mortality and postoperative complications. It has credibility for future use to study frailty within the NSQIP database. It also has potential in other databases and for clinical use. ((C) 2017 Published by Elsevier Inc. on behalf of the American College of Surgeons.)