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投稿时间：2023-07-12 网络发布日期：2024-02-20
投稿时间：2023-07-12 网络发布日期：2024-02-20
中文摘要: 目的 应用衰弱表型（FP）、衰弱量表（FRAIL）、临床衰弱量表（CFS）、蒂尔堡衰弱指数（TFI）、埃德蒙顿衰弱量表（EFS）和格列宁根衰弱量表（GFI）六种衰弱评估工具对老年结直肠癌患者进行术前衰弱评估并比较各量表对术后短期不良结局的预测水平。方法 选取2021年6月至2023年2月广西医科大学附属肿瘤医院290例拟行腹腔镜结直肠癌根治术的老年患者为研究对象，术前运用FP、FRAIL、CFS、TFI、EFS、GFI评估患者衰弱状态，收集基线资料及术后失能、并发症、住院时间延长、治疗费用增加等发生情况，采用受试者工作特征（ROC）曲线比较各量表对术后短期不良结局的预测水平。结果 FP、FRAIL、CFS、TFI、EFS、GFI评估显示，衰弱率分别为41.3%、29.6%、38.6%、65.5%、37.9%、38.6%，六种衰弱工具检出率比较差异有统计学意义（χ2=88.510，P＜0.01）。FP预测术后失能和治疗费用增加的AUC最大，分别为0.814和0.661，FRAIL预测术后并发症和住院时间延长的AUC最大，分别为0.741和0.754。结论 不同衰弱工具对衰弱的检出率差异较大，一致性较差；基于工具的特点及优势，同时考虑时间与成本，FRAIL预测术后短期不良结局的效能最佳。
Abstract:Objective Preoperative frailty in elderly patients with colorectal cancer was evaluated using six frailty assessment tools, frailty phenotype (FP), frailty scale (FRAIL), clinical frailty scale (CFS), Tilburg frailty index (TFI), Edmonton frailty scale (EFS) and Groningen frailty index (GFI). The predictive levels of each scale for short-term adverse outcomes after surgery were compared. Methods A total of 290 elderly patients undergoing laparoscopic radical resection of colorectal cancer in Cancer Hospital Affiliated of Guangxi Medical University from June 2021 to February 2023 were selected as the study subjects. FP, FRAIL, CFS, TFI, EFS, and GFI were used to assess the patient ‘s frailty status. Baseline data and postoperative disability, complications, prolonged hospital stay, and increased treatment costs were collected. The predictive levels of 6 scales for short-term adverse outcomes after surgery were evaluated by receiver operating characteristic (ROC) curves. Results The evaluation of FP, FRAIL, CFS, TFI, EFS and GFI showed that the frailty rate was 41.3%, 29.6%, 38.6%, 65.5%, 37.9% and 38.6%, respectively. There was a statistically significant difference in the detection rates of the six attenuation tools (χ2=88.510, P＜0.01). The maximum AUC for postoperative disability and increased treatment costs were 0.814 and 0.661 predicted by FP. The maximum AUC for postoperative complications and prolonged hospital stay were 0.741 and 0.754 predicted by FRAIL. Conclusion Different frailty tools have significant differences in the detection rate of frailty, with poor consistency; Based on the characteristics and advantages of the tool, taking into account both time and cost, FRAIL is the best predictor of short-term adverse outcomes after surgery.
keywords: Colorectal cancer, olderly Disability Frailty Frailty scale Clinical frailty scale Tilburg frailty index Edmonton frailty scale Groningen frailty index Hospital stay Medical expense
文章编号： 中图分类号：R735.3 文献标志码：A
基金项目:广西壮族自治区卫生和计划生育委员会中医药科技专项任务书（GZLC16-37）；广西医疗卫生适宜技术开发与推广应用项目（S2018109）
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引用文本：
陈思芮,陈英,吴莉莉,等.六种衰弱评估工具对老年结直肠癌患者术后短期不良结局的预测性能比较[J].中国临床研究,2024,37(2):236-241.
陈思芮,陈英,吴莉莉,等.六种衰弱评估工具对老年结直肠癌患者术后短期不良结局的预测性能比较[J].中国临床研究,2024,37(2):236-241.