老年神经外科手术中的脆弱性和术后风险:使用多维评估的前性队列研究
Chukwuma Okoye1,2,3, Valentina Stella4, Louis-Georges Roumy5
1School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. Chukwuma.okoye@unimib.it.
GeroScience
|January 7, 2026
概括
使用临床虚弱度表 (CFS) 和综合老年评估虚弱度指数 (CGA-FI) 的虚弱度评估预测了接受选择性神经外科手术的老年人手术后并发症. 纳入脆弱性查可以改善风险分层和患者护理.
科学领域:
- 老年医学 老年医学
- 神经外科 神经外科
- 手术风险评估手术风险评估
背景情况:
- 虚弱是老年人手术风险的一个关键因素.
- 它对选择性神经外科手术结果的影响尚未得到充分证实.
- 手术前的脆弱性评估对于优化患者管理至关重要.
研究的目的:
- 为了确定老年神经外科患者的脆弱性患病率.
- 为了比较三个脆弱性仪器:临床脆弱性尺度 (CFS),综合老年评估脆弱性指数 (CGA-FI) 和弗里德的脆弱性表型 (FFP).
- 评估虚弱和术后并发症之间的关联.
主要方法:
- 对181名年龄≥65岁,接受选择性神经外科手术的患者进行前性队列研究.
- 使用CFS,CGA-FI和FFP评估的手术前的脆弱性.
- 术后并发症系统地记录和分析使用多变量逻辑回归.
主要成果:
- 脆弱性患病率因仪器而异 (23.8% [CGA-FI]至44.2% [FFP]).
- 在CFS和CGA-FI (κ=0.65) 之间,一致性很大,在FFP.中适度.
- 通过CFS和CGA-FI的脆弱性独立预测了术后并发症的增加 (aOR分别为2.73和3.78).
结论:
- 脆弱性,特别是通过CFS和CGA-FI测量,是选择性神经外科手术中术后风险的重要预测因素.
- 常规的脆弱性评估可以增强外科手术期间风险分层.
- 将脆弱性评估整合到神经外科途径中可能会改善临床决策和结果.
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