Background

The aim of this study is to assess the impact of frailty on short-term outcomes after hepatectomy for colorectal liver metastasis (CRLM).

Methods

Patients were identified using the National Surgical Quality Improvement Program (NSQIP). Patients were divided into 3 categories using the 5-item Modified Frailty Index (mFI).

Results

There were 5230 patients included. 52%, 35%, and 13% had mFI scores of 0, 1, and ≥ 2 respectively. Patients with a ≥ 2 mFI score were more likely to experience minor complication (OR 1.34, 95% CI 1.06–1.69), major complication (OR 1.56, 95% CI 1.15–2.12), readmission (OR 1.55, 95% CI 1.12–2.14), unfavorable discharge (OR 2.48, 95% CI 1.62–3.80), 30-day mortality (OR 3.02, 95% CI 1.02–8.95), prolonged length of stay (OR 1.47, 95% CI 1.18–1.83), and bile leak (OR 1.51, 95% CI 1.02–2.24).

Conclusion

Frailty is associated with increased post-operative complications. The 5-item mFI can guide risk stratification, optimization, and counseling.

中文翻译：

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虚弱对因结直肠肝转移而接受肝切除术的患者的影响

 背景

本研究的目的是评估虚弱对结直肠肝转移（CRLM）肝切除术后短期结果的影响。

 方法

使用国家手术质量改进计划 (NSQIP) 来识别患者。使用 5 项改良衰弱指数 (mFI) 将患者分为 3 类。

 结果

共有 5230 名患者。 52%、35% 和 13% 的 mFI 分数分别为 0、1 和 ≥ 2。 mFI 评分 ≥ 2 的患者更有可能出现轻微并发症（OR 1.34，95% CI 1.06–1.69）、主要并发症（OR 1.56，95% CI 1.15–2.12）、再入院（OR 1.55，95% CI 1.12– 2.14）、出院不利（OR 2.48，95% CI 1.62–3.80）、30 天死亡率（OR 3.02，95% CI 1.02–8.95）、住院时间延长（OR 1.47，95% CI 1.18–1.83），以及胆漏（OR 1.51，95% CI 1.02–2.24）。

 结论

虚弱与术后并发症增加有关。 5项mFI可以指导风险分层、优化和咨询。