术前衰弱对结直肠癌患者术后感染并发症和预后的影响：倾向评分匹配研究。
Effect of preoperative frailty on postoperative infectious complications and prognosis in patients with colorectal cancer: a propensity score matching study.
机构信息
Department of Nursing, The First People's Hospital of Changzhou and the 3rd Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, Jiangsu, 213000, China.
Department of Nursing, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, 222061, China.
出版信息
World J Surg Oncol. 2024 Jun 12;22(1):154. doi: 10.1186/s12957-024-03437-y.
BACKGROUND
Few studies have explored the impact of preoperative frailty on infectious complications in patients with a diagnosis of colorectal cancer (CRC). Therefore, this study aimed to investigate the effect of preoperative frailty on postoperative infectious complications and prognosis in patients with CRC using propensity score matching (PSM).
METHODS
This prospective single-centre observational cohort study included 245 patients who underwent CRC surgery at the Department of Gastrointestinal Surgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University between August 2021 to May 2023. Patients were categorised into two groups: frail and non-frail. They were matched for confounders and 1:1 closest matching was performed using PSM. Rates of infectious complications, intensive care unit (ICU) admission, 30-day mortality, and 90-day mortality, as well as postoperative length of hospital stay, total length of hospital stay, and hospital costs, were compared between the two groups. Binary logistic regression using data following PSM to explore independent factors for relevant outcome measures.
RESULTS
After PSM, each confounding factor was evenly distributed between groups, and 75 pairs of patients were successfully matched. The incidence of intra-abdominal infectious complications was significantly higher in the frail group than in the non-frail group (10.7% vs. 1.3%, P < 0.05). There were no significant differences in ICU admission rate, postoperative length of hospital stay, total length of hospital stay, hospital costs, 30-day mortality rate, or 90-day mortality rate between the two groups (P > 0.05). Our logistic regression analysis result showed that preoperative frailty (OR = 12.014; 95% CI: 1.334-108.197; P = 0.027) was an independent factor for intra-abdominal infection.
CONCLUSIONS
The presence of preoperative frailty elevated the risk of postoperative intra-abdominal infectious complications in patients undergoing CRC surgery. Therefore, medical staff should assess preoperative frailty in patients with CRC early and provide targeted prehabilitation interventions.
背景
鲜有研究探讨术前衰弱对结直肠癌（CRC）患者感染并发症的影响。因此，本研究旨在使用倾向评分匹配（PSM）探讨术前衰弱对 CRC 患者术后感染并发症和预后的影响。
方法
本前瞻性单中心观察性队列研究纳入 2021 年 8 月至 2023 年 5 月在徐州医科大学附属连云港医院胃肠外科接受 CRC 手术的 245 例患者。患者分为衰弱组和非衰弱组。对混杂因素进行匹配，并使用 PSM 进行 1:1 最近匹配。比较两组感染并发症、重症监护病房（ICU）入住率、30 天死亡率、90 天死亡率以及术后住院时间、总住院时间和住院费用。使用 PSM 后的数据进行二元逻辑回归，以探讨相关结局指标的独立因素。
结果
PSM 后，各组混杂因素均衡分布，成功匹配 75 对患者。衰弱组的腹腔内感染并发症发生率明显高于非衰弱组（10.7%比 1.3%，P<0.05）。两组 ICU 入住率、术后住院时间、总住院时间、住院费用、30 天死亡率和 90 天死亡率差异均无统计学意义（P>0.05）。我们的逻辑回归分析结果显示，术前衰弱（OR=12.014；95%CI：1.334-108.197；P=0.027）是发生腹腔内感染的独立因素。
结论
术前衰弱增加了 CRC 手术患者术后腹腔内感染并发症的风险。因此，医务人员应早期评估 CRC 患者的术前衰弱情况，并提供针对性的康复干预。
Zotero 插件