改良衰弱指数联合麻醉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Predictive value of modified frailty index (mFI) combined with anesthesia grading for anesthesia-related adverse events in elderly patients undergoing laparoscopic surgery
鲁燕,程浩,陈永权
摘要(Abstract):
目的 评估改良衰弱指数(Modified frailty index, mFI)和美国麻醉医师协会(American 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。
关键词(KeyWords): 改良衰弱指数;麻醉分级;腹腔镜手术;麻醉相关不良事件
基金项目(Foundation): 国家青年科学基金项目(82000296);; 皖南医学院中青年科研基金项目(WK2020F10)
作者(Author): 鲁燕,程浩,陈永权
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