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http://hdl.handle.net/11375/26159
Title: | Frailty as a Predictor of Postoperative Morbidity and Mortality Following Liver Resection |
Authors: | McKechnie T Bao T Fabbro M Ruo L Serrano PE |
Department: | Surgery |
Keywords: | frailty;liver resection;morbidity;mortality;postoperative complications |
Publication Date: | 6-Nov-2020 |
Publisher: | SAGE Publications |
Abstract: | <jats:sec><jats:title>Background</jats:title><jats:p> Liver resection is commonly performed among patients at risk of being frail. Frailty can be used to assess perioperative risk. Thus, we evaluated frailty as a predictor of postoperative complications following liver resection using a validated modified frailty index (mFI). </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A retrospective cohort of consecutive patients undergoing liver resection (2011-2018) were stratified according to the mFI and classified as the following: high (≥.27) and low mFI (<.27). The effect of mFI on postoperative complications (Clavien-Dindo) was evaluated using multiple logistic regression, expressed as odds ratios (OR) and 95% CI. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of 409 patients, 58 (14%) had high mFI. There were no differences in type of liver resection (laparoscopic: 57% vs 55%, P = .766), number of segments resected (3 vs 4, P = .417), or operative time (257 vs 293 minutes, P = .097) between the high and low mFI groups, respectively. High mFI patients had a longer median length of hospital stay (9.5 vs 5 days, P < .001) and higher proportion of postoperative complications (79% vs 46%, P < .001), including minor complications (69% vs 42%, P < .001), major complications (50% vs 13%, P < .001), and 90-day postoperative mortality (12% vs 3.4%, P = .04). On multivariable analysis, longer operating time (OR 1.15, 95% CI, 1.03 to 1.27), higher number of segments resected (OR 1.43, 95% CI, 1.12 to 1.82), and high mFI (OR 6.74, 95% CI, 2.76 to 16.51) were independent predictors of major postoperative complications. </jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p> mFI predicts postoperative outcomes following liver resection and can be used as a risk stratification tool for patients being considered for surgery. </jats:p></jats:sec> |
URI: | http://hdl.handle.net/11375/26159 |
metadata.dc.identifier.doi: | 10.1177/0003134820949511 |
ISSN: | 0003-1348 1555-9823 |
Appears in Collections: | Surgery Publications |
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