The predictive value of modified frailty assessment tool for postoperative complications in elderly patients under-going flap reconstruction with oral squamous cell carcinoma
The predictive value of modified frailty assessment tool for postoperative complications in elderly patients under-going flap reconstruction with oral squamous cell carcinoma
PURPOSE:To explore the predictive value of modified frailty assessment for postoperative complications in elderly patients undergoing flap reconstruction with oral squamous cell carcinoma.METHODS:Retrospective analysis was performed on elderly patients(＞60 years old)who underwent oral squamous cell carcinoma resection with free-flap re-construction at Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2014 to December 2022.The patients'perioperative data were collected.According to the 5 modified frailty index(5-mFI),the in-dividuals were grouped into frail(≥2 points)and non-frail(＜2 points)group.The occurrence rate of short-term postopera-tive complication was calculated to determine the association between frailty and complications.Logistic regression analy-sis was applied to identify which postoperative complications were related to frailty with R 4.0.5 software package.RE-SULTS:A total of 1 083 patients were included.The rate of postoperative complications was 34.7％(376 cases).Among the patients,235 cases(21.7％)were classified as the frail group,while 848 cases(78.3％)were classified as the non-frail group.The frail group had a higher incidence of postoperative complications,longer stays in intensive-care unit and post-operative hospital,compared to the non-frail group,with significant difference(P＜0.05).After adjusting for confounding factors including gender,age,smoking,and alcohol consumption,multiple logistic regression analysis revealed that pul-monary complications(OR=4.76,95％CI:3.32-6.83,P＜0.001),flap complications(OR=2.65,95％CI:1.57-4.42,P＜0.001),and acute kidney injury(OR=3.31,95％CI:1.13-9.66,P＜0.05)were strongly correlated with frailty.CONCLUSIONS:The 5-mFI score is significantly correlated with postoperative complications in elderly patients undergoing flap reconstruc-tion surgery for oral squamous cell carcinoma,which provides a convenient and concise assessment tool for clinical work.
维普
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