Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study
Abstract Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI. Methods Patients...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-024-02391-6 |
| _version_ | 1797199673986908160 |
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| author | Xianwei Xiong Ting Zhang Huan Chen Yiling Jiang Shuangyu He Kun Qian Hui Li Xiong Guo Juying Jin |
| author_facet | Xianwei Xiong Ting Zhang Huan Chen Yiling Jiang Shuangyu He Kun Qian Hui Li Xiong Guo Juying Jin |
| author_sort | Xianwei Xiong |
| collection | DOAJ |
| description | Abstract Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI. Methods Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected. Results The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572–6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577–0.730] and GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery. Conclusions Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI. Trial registration This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/ . |
| first_indexed | 2024-04-24T07:19:30Z |
| format | Article |
| id | doaj.art-61f92128a86e468281a8d09ecbcfb74d |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-24T07:19:30Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-61f92128a86e468281a8d09ecbcfb74d2024-04-21T11:07:22ZengBMCBMC Surgery1471-24822024-04-0124111010.1186/s12893-024-02391-6Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort studyXianwei Xiong0Ting Zhang1Huan Chen2Yiling Jiang3Shuangyu He4Kun Qian5Hui Li6Xiong Guo7Juying Jin8Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI. Methods Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected. Results The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572–6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577–0.730] and GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery. Conclusions Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI. Trial registration This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/ .https://doi.org/10.1186/s12893-024-02391-6Prolonged postoperative ileusFrailtyElderly patientsPredictionMajor abdominal surgery |
| spellingShingle | Xianwei Xiong Ting Zhang Huan Chen Yiling Jiang Shuangyu He Kun Qian Hui Li Xiong Guo Juying Jin Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study BMC Surgery Prolonged postoperative ileus Frailty Elderly patients Prediction Major abdominal surgery |
| title | Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study |
| title_full | Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study |
| title_fullStr | Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study |
| title_full_unstemmed | Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study |
| title_short | Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study |
| title_sort | comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients a prospective cohort study |
| topic | Prolonged postoperative ileus Frailty Elderly patients Prediction Major abdominal surgery |
| url | https://doi.org/10.1186/s12893-024-02391-6 |
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