Background

Frailty is an aggregate variable that encompasses debilitating geriatric conditions, which potentially affects postoperative outcomes. In this study, we evaluate the relationship between clinical frailty and post-cholecystectomy outcomes using a national registry of hospitalized patients.

Methods

2011–2017 National Inpatient Sample database was used to identify patients who underwent cholecystectomy. Patients were stratified using the Johns Hopkins ACG frailty definition into binary (frailty and no-frailty) and tripartite frailty (frailty, prefrailty, no-frailty) indicators. The controls were matched to study cohort using 1:1 propensity score-matching and postoperative outcomes were compared.

Results

Post-match, using the binary term, frail patients (n = 40,067) had higher rates of mortality (OR 2.07 95%CI 1.90–2.25), length of stay, costs, and complications. In multivariate, frailty was associated with higher mortality (aOR 2.06 95%CI 1.89–2.24). When using tripartite frailty term, prefrail (n = 35,595) and frail (n = 4472) patients had higher mortality (prefrailty: OR 2.04 95%CI 1.86–2.23; frailty: OR 2.49 95%CI 1.99–3.13), length of stay, costs, and complications. In multivariate, prefrailty and frailty were associated with higher mortality (prefrailty: aOR 2.02 95%CI 1.84–2.21; frailty: aOR 2.54 95%CI 2.02–3.19).

Conclusion

This study shows the presence of frailty (and prefrailty) is an independent risk factor of adverse postoperative outcomes in patients undergoing cholecystectomy.

中文翻译：

---

衰弱对胆囊切除术患者术后结局的影响：2011-2017 年美国医院的倾向评分匹配分析

背景

虚弱是一个综合变量，包括使人衰弱的老年病，这可能会影响术后结果。在这项研究中，我们使用全国住院患者登记处评估临床虚弱与胆囊切除术后结果之间的关系。

方法

2011-2017 年全国住院患者样本数据库用于识别接受胆囊切除术的患者。使用约翰霍普金斯大学 ACG 衰弱定义将患者分层为二元（衰弱和非衰弱）和三元衰弱（衰弱、预衰弱、非衰弱）指标。使用 1:1 倾向评分匹配将对照组与研究队列匹配，并比较术后结果。

结果

赛后，使用二元术语，体弱的患者（n = 40,067）具有更高的死亡率（OR 2.07 95%CI 1.90-2.25）、住院时间、费用和并发症。在多变量中，虚弱与较高的死亡率相关（aOR 2.06 95%CI 1.89–2.24）。使用三方衰弱术语时，衰弱前 (n = 35,595) 和衰弱 (n = 4472) 患者死亡率较高（衰弱前：OR 2.04 95%CI 1.86–2.23；衰弱：OR 2.49 95%CI 1.99–3.13），住院时间、成本和并发症。在多变量中，衰弱前和衰弱与较高的死亡率相关（衰弱前：aOR 2.02 95%CI 1.84-2.21；衰弱：aOR 2.54 95%CI 2.02-3.19）。

结论

这项研究表明，体弱（和体弱前体质）的存在是胆囊切除术患者术后不良结局的独立危险因素。