目的 评估改良衰弱指数(Modified frailty index,mFI)和美国麻醉医师协会(Ameri-can Society of Anesthesiologists,ASA)分级对老年腹腔镜手术患者麻醉相关不良事件的预测价值.方法 收集皖南医学院第一附属医院2019年12月至2023年10月行老年腹腔镜手术的102例患者,根据患者术后是否发生麻醉相关不良事件分为发生组(n=23)、未发生组(n=79),比较两组临床资料、mFI、ASA分级,Spearman相关性分析mFI与ASA分级关系,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析mFI、ASA分级对麻醉相关不良事件的预测价值.结果 与未发生组比较,发生组年龄、体质指数(Body mass index,BMI)、合并糖尿病、慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)比例升高,mFI 和 ASA 分级升高,差异有统计学意义(P＜0.05).mFI与ASA分级呈正相关(r=0.627,P＜0.001);衰弱患者发生麻醉相关不良事件的风险是非衰弱患者的4.580倍,ASA分级Ⅲ级患者发生麻醉相关不良事件的风险是Ⅰ～Ⅱ级患者的5.152倍(P＜0.05);mFI、ASA分级联合预测麻醉相关不良事件的预测价值优于mFI、ASA分级单独预测(P＜0.05).结论 mFI、ASA分级联合能有效预测老年腹腔镜手术患者麻醉相关不良事件发生情况,为临床预测麻醉相关不良事件提供理论依据.
Predictive value of modified frailty index(mFI)combined with anesthesia grading for anesthesia-related adverse events in elderly patients undergoing laparoscopic surgery
Objective To assess the predictive value of modified frailty index(mFI)and American Society of Anesthesiologists(ASA)anesthesia classification for postoperative anesthesia-related adverse events in elderly patients undergoing laparoscopic surgery.Methods 102 elderly patients who underwent laparo-scopic surgery at the hospital from December 2019 to October 2023 were collected.The patients were di-vided into 2 groups based on whether anesthesia related adverse events occurred after the surgery:occur-rence group(n=23)and non occurrence group(n=79).Clinical data,mFI and ASA grading were com-pared between the 2 groups.Spearman correlation analysis was conducted to examine the relationship be-tween mFI and ASA grading.Receiver Operating Characteristic(ROC)curves were used to analyze the predictive value of mFI and ASA grading for anesthesia related adverse events.Results Compared with the non occurrence group,the incidence group had a higher proportion of age,BMI,diabetes and COPD,the mFI and ASA grading of the occurring group was increased,and the difference was statistically signifi-cant(P＜0.05).mFI was positively correlated with ASA classification(r=0.627,P＜0.001).The risk of anesthesia-related adverse events in frail patients was 4.580 times that of non-frail patients,and the risk of anesthesia-related adverse events in patients with ASA grade Ⅲ was 5.152 times that in Ⅰ～Ⅱ grade patients(P＜0.05);The combined predictive value of mFI and ASA in predicting anesthesia-related ad-verse events was better than that of mFI and ASA alone(P＜0.05).Conclusion The combination of mFI and ASA classification can effectively predict the occurrence of postoperative anesthesia-related adverse events in elderly patients with laparoscopic surgery,and it can provide a theoretical basis for clinical diag-nosis of anesthesia-related adverse events.
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