Introduction

Frailty has been proven to lead to higher morbidity and mortality rates in surgical patients, independent of age. The modified Frailty Index (mFI) is a validated means of assessing for frailty.

Aim of study

The aim of this study is to ascertain if the mFI correlates with clinician experience in turning down patients for abdominal aortic aneurysm (AAA) surgery and/or AAA surveillance.

Methods

A contemporaneously recorded database of all AAA patients treated during 2017 at a large University Hospital was reviewed. Patients were categorised into the following groups; continued surveillance, turned down for surveillance, patient declined surveillance, patient offered surgery, patient turned down for surgery and patient declined surgery.

Results

One hundred and forty two patients were included. Twenty-eight patients <5.5 cm were turned down for surveillance with a mFI of 0.27. Forty-one patients <5.5 cm continued with surveillance, with a mFI of 0.09 (p < 0.0001). Eighteen patients >5.5 cm were turned down for surgical intervention with a median mFI of 0.36. Forty-two patients were offered surgical intervention had a median mFI of 0.09 (p < 0.0001).

Conclusion

Frailty is associated with higher morbidity and mortality amongst frail patient cohorts. mFI is a valid and easy to use tool to predict perioperative outcomes in AAA intervention. It correlates well with senior, experienced clinicians’ decision-making in relation to who should and who should not undergo elective AAA surgery and those patients who should have ongoing aneurysm surveillance.

中文翻译：

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改良衰弱指数 (mFI) 用于选择性肾下腹主动脉瘤 (AAA) 干预和持续监测的可靠性

介绍

事实证明，虚弱会导致手术患者更高的发病率和死亡率，与年龄无关。改良衰弱指数 (mFI) 是一种经过验证的衰弱评估方法。

学习目的

本研究的目的是确定 mFI 是否与临床医生拒绝患者接受腹主动脉瘤 (AAA) 手术和/或 AAA 监测的经验相关。

方法

对 2017 年在一家大型大学医院接受治疗的所有 AAA 患者的同期记录数据库进行了审查。患者被分为以下几组：持续监测、拒绝监测、患者拒绝监测、患者提出手术、患者拒绝手术、患者拒绝手术。

结果

其中包括一百四十二名患者。28 名 <5.5 cm 的患者因 mFI 为 0.27 而被拒绝接受监测。41 名 <5.5 cm 的患者继续进行监测，mFI 为 0.09 (p < 0.0001)。18 名>5.5 cm 的患者被拒绝接受手术干预，中位 mFI 为 0.36。接受手术干预的 42 名患者的中位 mFI 为 0.09 (p < 0.0001)。

结论

虚弱与虚弱患者群体中较高的发病率和死亡率相关。mFI 是一种有效且易于使用的工具，可预测 AAA 干预的围手术期结果。它与经验丰富的资深临床医生关于谁应该和谁不应该接受选择性 AAA 手术以及哪些患者应该进行持续动脉瘤监测的决策密切相关。