Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database
Abstract Background This study aimed to investigate the potential effect of preoperative frailty on postoperative clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods Data of patients aged 18 years and older who were diagnosed with subarachnoid hemorrhage or intracer...
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| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-03141-0 |
| _version_ | 1818207553304133632 |
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| author | Yubin Guo Hui Wu Wenhua Sun Xiang Hu Jiong Dai |
| author_facet | Yubin Guo Hui Wu Wenhua Sun Xiang Hu Jiong Dai |
| author_sort | Yubin Guo |
| collection | DOAJ |
| description | Abstract Background This study aimed to investigate the potential effect of preoperative frailty on postoperative clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods Data of patients aged 18 years and older who were diagnosed with subarachnoid hemorrhage or intracerebral hemorrhage, underwent aneurysm repair surgical intervention from 2005 to 2014. A retrospective database analysis was performed based on U.S. National Inpatient Sample (NIS) from 2005 to 2014. Frailty was determined using the Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses indicator. Patients were stratified into frail and non-frail groups and the study endpoints were incidence of postoperative complications and related adverse clinical outcomes. Results Among 20,527 included aSAH patients, 2303 (11.2%) were frail and 18,224 (88.8%) were non-frail. Significant differences were found between frailty and non-frailty groups in the four clinical outcomes (all p < 0.05). Multivariate analysis showed that frailty was associated with significant higher risks of discharge to institutional care (aOR: 2.50, 95%CI: 2.10–2.97), tracheostomy or gastrostomy tube replacement (aOR: 4.41, 95%CI: 3.81–5.10) and postoperative complications (aOR: 3.29, 95%CI: 2.55–4.25) but a lower risk of death in hospital (aOR: 0.40, 95%CI: 0.33–0.49) as compared with non-frailty. Stratified analysis showed the impact of frailty on some of the outcomes were greater among patients younger than 65 years than their older counterparts. Conclusions Frailty is significantly correlated with the increased risk of discharge to institutional care, tracheostomy or gastrostomy tube placement, and postoperative complications but with the reduced risk of in-hospital mortality outcomes after aneurysm repair. Frailty seems to have greater impact among younger adults than older ones. Baseline frailty evaluation could be applied to risk stratification for aSAH patients who were undergoing surgery. |
| first_indexed | 2024-12-12T04:30:45Z |
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| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T04:30:45Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj.art-b29935f19088422aba7e2557fc12cac72022-12-22T00:38:06ZengBMCBMC Geriatrics1471-23182022-05-0122111310.1186/s12877-022-03141-0Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample databaseYubin Guo0Hui Wu1Wenhua Sun2Xiang Hu3Jiong Dai4Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of MedicineDepartment of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of MedicineDepartment of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of MedicineDepartment of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of MedicineDepartment of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of MedicineAbstract Background This study aimed to investigate the potential effect of preoperative frailty on postoperative clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods Data of patients aged 18 years and older who were diagnosed with subarachnoid hemorrhage or intracerebral hemorrhage, underwent aneurysm repair surgical intervention from 2005 to 2014. A retrospective database analysis was performed based on U.S. National Inpatient Sample (NIS) from 2005 to 2014. Frailty was determined using the Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnoses indicator. Patients were stratified into frail and non-frail groups and the study endpoints were incidence of postoperative complications and related adverse clinical outcomes. Results Among 20,527 included aSAH patients, 2303 (11.2%) were frail and 18,224 (88.8%) were non-frail. Significant differences were found between frailty and non-frailty groups in the four clinical outcomes (all p < 0.05). Multivariate analysis showed that frailty was associated with significant higher risks of discharge to institutional care (aOR: 2.50, 95%CI: 2.10–2.97), tracheostomy or gastrostomy tube replacement (aOR: 4.41, 95%CI: 3.81–5.10) and postoperative complications (aOR: 3.29, 95%CI: 2.55–4.25) but a lower risk of death in hospital (aOR: 0.40, 95%CI: 0.33–0.49) as compared with non-frailty. Stratified analysis showed the impact of frailty on some of the outcomes were greater among patients younger than 65 years than their older counterparts. Conclusions Frailty is significantly correlated with the increased risk of discharge to institutional care, tracheostomy or gastrostomy tube placement, and postoperative complications but with the reduced risk of in-hospital mortality outcomes after aneurysm repair. Frailty seems to have greater impact among younger adults than older ones. Baseline frailty evaluation could be applied to risk stratification for aSAH patients who were undergoing surgery.https://doi.org/10.1186/s12877-022-03141-0FrailtyAneurysmal subarachnoid hemorrhage (aSAH)Postoperative outcomesNational inpatient sample (NIS) |
| spellingShingle | Yubin Guo Hui Wu Wenhua Sun Xiang Hu Jiong Dai Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database BMC Geriatrics Frailty Aneurysmal subarachnoid hemorrhage (aSAH) Postoperative outcomes National inpatient sample (NIS) |
| title | Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database |
| title_full | Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database |
| title_fullStr | Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database |
| title_full_unstemmed | Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database |
| title_short | Effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage: results from the National Inpatient Sample database |
| title_sort | effects of frailty on postoperative clinical outcomes of aneurysmal subarachnoid hemorrhage results from the national inpatient sample database |
| topic | Frailty Aneurysmal subarachnoid hemorrhage (aSAH) Postoperative outcomes National inpatient sample (NIS) |
| url | https://doi.org/10.1186/s12877-022-03141-0 |
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