The value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly patients with hip fractures
10.3760/cma.j.issn.0254-9026.2024.01.010
- VernacularTitle:改良衰弱指数-5对老年髋部骨折患者术后并发症及死亡率的影响
- Author:
Zongyan XIE
1
;
Shuyu ZHANG
;
Xuhong WANG
;
Junrong GUO
;
Jian XI
;
Feifei ZHAO
;
Lu JIN
;
Liang LIU
Author Information
1. 首都医科大学附属北京潞河医院临床药理科，北京 101100
- Keywords:
Hip fractures;
Frail elderly;
Postoperative complications;
Mortality;
Modified 5-factor frailty index
- From:
Chinese Journal of Geriatrics
2024;43(1):50-55
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly hip fracture patients.Methods:In this retrospective study, clinical data were collected of hip fracture patients aged 60 years and above surgically treated at Beijing Luhe Hospital affiliated to Capital Medical University between January 2015 and December 2019.Patients' group assignment was based on whether the modified frailty index score was ≤1 or ≥2, and a post-surgery follow-up was conducted for survival at 30 days, 1 year, 2 years, and 4 years, which was analyzed by the Kaplan-Meier method.Multivariate Cox regression analysis was used to identify factors affecting death in elderly patients.Results:A total of 1 208 patients were included, with 890 in the group with the index score ≤1 and 318 in the group with the index score ≥2.There was no difference in mortality at 30 days(1.6% or 14/890 vs.1.9% or 6/318, P=0.707), 1-year(11.3% or 99/874 vs.11.6% or 36/310, P=0.917), 2-years(19.7% or 168/852 vs.24.3% or 73/300, P=0.099)and 4-years(44.0% or 238/541 vs.51.5% or 106/206, P=0.071). The incidence of postoperative complications in the group with the score ≥2 was higher(14.8% or 47/318 vs.9.7% or 86/890, P=0.012), including the incidence of stroke(6.3% or 20/318 vs.1.8% or 16/890, P<0.001)and the incidence of postoperative pneumonia(6.0% or 19/318 vs.3.1% or 28/890, P=0.029), and the differences were statistically significant.Multivariate Cox regression analysis showed that age, being female, the Charlson comorbidity index score and low hemoglobin at admission were risk factors for 1-year, 2-year and 4-year mortality post-surgery(all P<0.05), while the modified frailty index score had no correlation with postoperative mortality. Conclusions:A modified frailty index ≥2 is predictive of increased risk of postoperative pneumonia and stroke in patients with hip fractures, but is not correlated with the risk of postoperative mortality.
