当前位置:
X-MOL 学术
›
Bone Joint J.
›
论文详情
Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Modified Frailty Index as a novel predictor for the incidence and severity of postoperative complications after spinal metastases surgery.
The Bone & Joint Journal ( IF 4.9 ) Pub Date : 2024-12-01 , DOI: 10.1302/0301-620x.106b12.bjj-2024-0100.r1 Tomoya Matsuo,Yutaro Kanda,Yoshitada Sakai,Takashi Yurube,Yoshiki Takeoka,Kunihiko Miyazaki,Ryosuke Kuroda,Kenichiro Kakutani
The Bone & Joint Journal ( IF 4.9 ) Pub Date : 2024-12-01 , DOI: 10.1302/0301-620x.106b12.bjj-2024-0100.r1 Tomoya Matsuo,Yutaro Kanda,Yoshitada Sakai,Takashi Yurube,Yoshiki Takeoka,Kunihiko Miyazaki,Ryosuke Kuroda,Kenichiro Kakutani
Aims
Frailty has been gathering attention as a factor to predict surgical outcomes. However, the association of frailty with postoperative complications remains controversial in spinal metastases surgery. We therefore designed a prospective study to elucidate risk factors for postoperative complications with a focus on frailty.
Methods
We prospectively analyzed 241 patients with spinal metastasis who underwent palliative surgery from June 2015 to December 2021. Postoperative complications were assessed by the Clavien-Dindo classification; scores of ≥ Grade II were defined as complications. Data were collected regarding demographics (age, sex, BMI, and primary cancer) and preoperative clinical factors (new Katagiri score, Frankel grade, performance status, radiotherapy, chemotherapy, spinal instability neoplastic score, modified Frailty Index-11 (mFI), diabetes, and serum albumin levels). Univariate and multivariate analyses were developed to identify risk factors for postoperative complications (p < 0.05).
Results
Overall, 57 postoperative complications occurred in 47 of 241 (19.5%) patients. The most common complications were wound infection/dehiscence, urinary tract infection, and pneumonia. Univariate analysis identified preoperative radiotherapy (p = 0.028), mFI (p < 0.001), blood loss ≥ 500 ml (p = 0.016), and preoperative molecular targeted drugs (p = 0.030) as potential risk factors. From the receiver operating characteristic curve, the clinically optimal cut-off value of mFI was 0.27 (sensitivity, 46.8%; specificity, 79.9%). Multivariate analysis identified mFI ≥ 0.27 (odds ratio (OR) 2.94 (95% CI 1.44 to 5.98); p = 0.003) and preoperative radiotherapy (OR 2.11 (95% CI 1.00 to 4.46); p = 0.049) as significant risk factors. In particular, urinary tract infection (p = 0.012) and pneumonia (p = 0.037) were associated with mFI ≥ 0.27. Furthermore, the severity of postoperative complications was positively correlated with mFI (p < 0.001).
Conclusion
The mFI is a useful tool to predict the incidence and the severity of postoperative complications in spinal metastases surgery.
中文翻译:
改良虚弱指数作为脊柱转移手术后并发症发生率和严重程度的新预测因子。
目的 衰弱作为预测手术结果的一个因素一直受到关注。然而,在脊柱转移手术中,虚弱与术后并发症的相关性仍然存在争议。因此,我们设计了一项前瞻性研究来阐明术后并发症的危险因素,重点是虚弱。方法 前瞻性分析 2015年6月至 2021年12月接受姑息手术的 241 例脊柱转移患者。通过 Clavien-Dindo 分类评估术后并发症;≥ II 级评分定义为并发症。收集有关人口统计学 (年龄、性别、BMI 和原发癌) 和术前临床因素 (新 Katagiri 评分、Frankel 分级、体能状态、放疗、化疗、脊柱不稳定肿瘤评分、改良虚弱指数 11 (mFI) 、糖尿病和血清白蛋白水平)。开发单变量和多变量分析以确定术后并发症的危险因素 (p < 0.05)。结果 总体而言,241 例患者中有 47 例 (19.5%) 发生术后并发症。最常见的并发症是伤口感染/裂开、尿路感染和肺炎。单变量分析确定术前放疗 (p = 0.028)、mFI (p < 0.001)、失血 ≥ 500 ml (p = 0.016) 和术前分子靶向药物 (p = 0.030) 是潜在的危险因素。从受试者工作特征曲线来看,mFI 的临床最佳临界值为 0.27 (敏感性,46.8%;特异性,79.9%)。多变量分析确定 mFI ≥ 0.27 (比值比 (OR) 2.94 (95% CI 1.44 至 5.98);p = 0.003)和术前放疗 (OR 2.11 (95% CI 1.00 - 4.46);p = 0.049) 是重要的危险因素。 特别是,尿路感染 (p = 0.012) 和肺炎 (p = 0.037) 与 mFI ≥ 0.27 相关。此外,术后并发症的严重程度与 mFI 呈正相关 (p < 0.001)。结论 mFI 是预测脊柱转移手术术后并发症发生率和严重程度的有用工具。
更新日期:2024-12-01
中文翻译:
改良虚弱指数作为脊柱转移手术后并发症发生率和严重程度的新预测因子。
目的 衰弱作为预测手术结果的一个因素一直受到关注。然而,在脊柱转移手术中,虚弱与术后并发症的相关性仍然存在争议。因此,我们设计了一项前瞻性研究来阐明术后并发症的危险因素,重点是虚弱。方法 前瞻性分析 2015年6月至 2021年12月接受姑息手术的 241 例脊柱转移患者。通过 Clavien-Dindo 分类评估术后并发症;≥ II 级评分定义为并发症。收集有关人口统计学 (年龄、性别、BMI 和原发癌) 和术前临床因素 (新 Katagiri 评分、Frankel 分级、体能状态、放疗、化疗、脊柱不稳定肿瘤评分、改良虚弱指数 11 (mFI) 、糖尿病和血清白蛋白水平)。开发单变量和多变量分析以确定术后并发症的危险因素 (p < 0.05)。结果 总体而言,241 例患者中有 47 例 (19.5%) 发生术后并发症。最常见的并发症是伤口感染/裂开、尿路感染和肺炎。单变量分析确定术前放疗 (p = 0.028)、mFI (p < 0.001)、失血 ≥ 500 ml (p = 0.016) 和术前分子靶向药物 (p = 0.030) 是潜在的危险因素。从受试者工作特征曲线来看,mFI 的临床最佳临界值为 0.27 (敏感性,46.8%;特异性,79.9%)。多变量分析确定 mFI ≥ 0.27 (比值比 (OR) 2.94 (95% CI 1.44 至 5.98);p = 0.003)和术前放疗 (OR 2.11 (95% CI 1.00 - 4.46);p = 0.049) 是重要的危险因素。 特别是,尿路感染 (p = 0.012) 和肺炎 (p = 0.037) 与 mFI ≥ 0.27 相关。此外,术后并发症的严重程度与 mFI 呈正相关 (p < 0.001)。结论 mFI 是预测脊柱转移手术术后并发症发生率和严重程度的有用工具。