Dandan Chen1, Yi Ding1, Wenlan Zhu1, Tingting Fang2, Nan Dong1, Fenglai Yuan3, Qin Guo4, Zhiqiang Wang5, Jiru Zhang6. 1. Department of Anesthesiology, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Wuxi, 214125, People's Republic of China. 2. Intensive Care Unit, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China. 3. Institute of Integrated Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China. 4. Clinical Laboratory, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China. 5. Department of Thoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People's Republic of China. 6. Department of Anesthesiology, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Wuxi, 214125, People's Republic of China. zjr2010508@126.com.
Abstract
BACKGROUND: Although frailty as a common geriatric syndrome is associated with postoperative complications, its relationship with postoperative pulmonary complications (PPCs) following pulmonary resections in elderly patients is unclear. AIMS: To investigate the relationship between frailty and PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections and explore the effect of the addition of frailty assessment to PPC risk index and ASA on their predictive ability. METHODS: In a prospective cohort study, we measured frailty status using the FRAIL scale in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Multivariate analysis was used to identify the relationship between frailty and PPCs. Receiver operating characteristic curves were used to examine the predictive power of frailty and other assessment tools. RESULTS: 227 patients were analyzed in the study. The prevalence of PPCs was 24.7%. Significant differences between patients with and without PPCs were observed in the following aspects: BMI, smoking, COPD, respiratory infection within the last month, FEV1/FVC ratio, creatinine, ASA, frailty and PPC risk index (p < 0.05, respectively). After adjusting for all covariates, frailty was significantly related to PPCs in elderly patients (odds ratio: 6.33, 95% confidence interval: 2.45-16.37). Combined with frailty assessment, the area under the curve for ASA class and PPC risk index was increased to 0.759 (95% CI 0.687-0.831) and 0.821 (95% CI 0.758-0.883). CONCLUSIONS: Frailty was associated with PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Combined with the frailty assessment, the predictive power of the PPC risk index and ASA class was improved.
BACKGROUND: Although frailty as a common geriatric syndrome is associated with postoperative complications, its relationship with postoperative pulmonary complications (PPCs) following pulmonary resections in elderly patients is unclear. AIMS: To investigate the relationship between frailty and PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections and explore the effect of the addition of frailty assessment to PPC risk index and ASA on their predictive ability. METHODS: In a prospective cohort study, we measured frailty status using the FRAIL scale in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Multivariate analysis was used to identify the relationship between frailty and PPCs. Receiver operating characteristic curves were used to examine the predictive power of frailty and other assessment tools. RESULTS: 227 patients were analyzed in the study. The prevalence of PPCs was 24.7%. Significant differences between patients with and without PPCs were observed in the following aspects: BMI, smoking, COPD, respiratory infection within the last month, FEV1/FVC ratio, creatinine, ASA, frailty and PPC risk index (p < 0.05, respectively). After adjusting for all covariates, frailty was significantly related to PPCs in elderly patients (odds ratio: 6.33, 95% confidence interval: 2.45-16.37). Combined with frailty assessment, the area under the curve for ASA class and PPC risk index was increased to 0.759 (95% CI 0.687-0.831) and 0.821 (95% CI 0.758-0.883). CONCLUSIONS: Frailty was associated with PPCs in elderly patients undergoing video-assisted thoracoscopic pulmonary resections. Combined with the frailty assessment, the predictive power of the PPC risk index and ASA class was improved.
Authors: Erik H J Hulzebos; Paul J M Helders; Nine J Favié; Rob A De Bie; Aart Brutel de la Riviere; Nico L U Van Meeteren Journal: JAMA Date: 2006-10-18 Impact factor: 56.272
Authors: Daniel I McIsaac; Monica Taljaard; Gregory L Bryson; Paul E Beaulé; Sylvain Gagne; Gavin Hamilton; Emily Hladkowicz; Allen Huang; John Joanisse; Luke T Lavallée; David MacDonald; Husein Moloo; Kednapa Thavorn; Carl van Walraven; Homer Yang; Alan J Forster Journal: Br J Anaesth Date: 2020-08-07 Impact factor: 9.166
Authors: John E Morley; Bruno Vellas; G Abellan van Kan; Stefan D Anker; Juergen M Bauer; Roberto Bernabei; Matteo Cesari; W C Chumlea; Wolfram Doehner; Jonathan Evans; Linda P Fried; Jack M Guralnik; Paul R Katz; Theodore K Malmstrom; Roger J McCarter; Luis M Gutierrez Robledo; Ken Rockwood; Stephan von Haehling; Maurits F Vandewoude; Jeremy Walston Journal: J Am Med Dir Assoc Date: 2013-06 Impact factor: 4.669
Authors: Yunjoo Im; Hye Yun Park; Sumin Shin; Sun Hye Shin; Hyun Lee; Joong Hyun Ahn; Insuk Sohn; Jong Ho Cho; Hong Kwan Kim; Jae Ill Zo; Young Mog Shim; Ho Yun Lee; Jhingook Kim Journal: Respir Res Date: 2019-07-04