3种衰弱评估工具对老年腹部手术患者术后并发症预测效能的比较分析

目的：比较衰弱表型（Frailty Phenotype，FP)、衰弱量表（Frail scale，FS）、埃德蒙特衰弱量表（The Edmonton Frail Scale，EFS）3种衰弱评估工具对老年腹部手术患者术后并发症的预测效能，以期为衰弱评估工具的选择提供参考。方法：便利选取某三级甲等医院年龄≥60岁的老年腹部手术患者184例，采用FP、FS、EFS评估患者的衰弱状态，收集患者的一般资料、手术类型、手术方式以及术后并发症的资料。应用?字2检验，通过受试者工作特征(receiver operating characteristic，ROC) 曲线分析FP、FS和EFS对老年腹部手术患者术后并发症的预测作用。结果：184例老年腹部手术患者FP、FS、EFS衰弱的检出率分别为22.3%、16.8%、22.2%， 3种评估工具的衰弱检出率比较差异无统计学意义（P＞0.05）。FP预测老年腹部手术患者术后并发症发生的ROC面积为0.798，高于FS、EFS的0.681和0.670（P＜0.05）。结论：3种衰弱评估工具对老年腹部手术患者的衰弱检出率具有一致性。与FS、EFS相比较，FP更能够有效预测老年腹部手术患者术后并发症的发生。

Comparison of the efficacy of three frailty assessment tools on predicting postoperative complications in elderly patients undergoing abdominal surgery

Objective：To compare the efficacy of Frailty Phenotype(FP), Frail Scale(FS) and The Edmonton Frail Scale (EFS) on predicting the postoperative complications in elderly patients undergoing abdominal surgery, so as to provide reference for the selection of frailty assessment tools. Methods: A total of 184 elderly patients undergoing abdominal surgery aged ≥60 years old in a tertiary Class A hospital were included by convenience sampling method. The premorbid frailty status was assessed by FP, FS and EFS. The general information, the type of operation, the operation method and the postoperative complications were collected. Chi-square test was applied and the receiver operating characteristic (ROC) was used to evaluate the predictive efficacy of FP, FS and EFS. Results: The frailty detection rates of FP、FS and EFS in 184 elderly patients undergoing abdominal surgery were 22.3%,16.8%and 22.2%,resectively. There was no significant difference in the frailty detection rates of the three assessment tools（P＞0.05）. The area under the curve (AUC) in prediction of postoperative complications in elderly patients with abdominal elective surgery using FP was 0.798, which was significantly higher than that of FS(0.681) and EFS(0.670)（P＜0.05）. Conclusion: The frailty of elderly patients undergoing abdominal surgery were consistent with the three frailty assessment tools. Compared with FS and EFS, FP has higher efficacy on predicting the occurrence of postoperative complications in elderly patients undergoing abdominal surgery.