Cargando…
The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO)
BACKGROUND: SBO is a potentially life-threatening condition that often affects older patients. Frailty, more than age, is expected to play a crucial role in predicting SBO prognosis in this population. This study aims to define the influence of Clinical Frailty Scale (CFS) on mortality and major com...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579164/ https://www.ncbi.nlm.nih.gov/pubmed/37674098 http://dx.doi.org/10.1007/s11605-023-05820-8 |
_version_ | 1785121665839005696 |
---|---|
author | Laterza, Vito Covino, Marcello Schena, Carlo Alberto Russo, Andrea Salini, Sara Polla, Davide Della de’Angelis, Nicola Quero, Giuseppe Tondolo, Vincenzo La Greca, Antonio Merra, Giuseppe Sganga, Gabriele Gasbarrini, Antonio Franceschi, Francesco Landi, Francesco Alfieri, Sergio Rosa, Fausto |
author_facet | Laterza, Vito Covino, Marcello Schena, Carlo Alberto Russo, Andrea Salini, Sara Polla, Davide Della de’Angelis, Nicola Quero, Giuseppe Tondolo, Vincenzo La Greca, Antonio Merra, Giuseppe Sganga, Gabriele Gasbarrini, Antonio Franceschi, Francesco Landi, Francesco Alfieri, Sergio Rosa, Fausto |
author_sort | Laterza, Vito |
collection | PubMed |
description | BACKGROUND: SBO is a potentially life-threatening condition that often affects older patients. Frailty, more than age, is expected to play a crucial role in predicting SBO prognosis in this population. This study aims to define the influence of Clinical Frailty Scale (CFS) on mortality and major complications in patients ≥80 years with diagnosis of SBO at the emergency department (ED). METHODS: All patients aged ≥80 years admitted to our ED for SBO from January 2015 to September 2020 were enrolled. Frailty was assessed through the CFS, and then analyzed both as a continuous and a dichotomous variable. The endpoints were in-hospital mortality and major complications. RESULTS: A total of 424 patients were enrolled. Higher mortality (20.8% vs 8.6%, p<0.001), longer hospital stay (9 [range 5–14] days vs 7 [range 4–12] days, p=0.014), and higher rate of major complications (29.9% vs 17.9%, p=0.004) were associated with CFS ≥7. CFS score and bloodstream infection were the only independent prognostic factors for mortality (OR 1.72 [CI: 1.29–2.29], p<0.001; OR 4.69 [CI: 1.74–12.6], p=0.002, respectively). Furthermore, CFS score, male sex and surgery were predictive factors for major complications (OR 1.41 [CI: 1.13–1.75], p=0.002; OR 1.67 [CI: 1.03–2.71], p=0.038); OR 1.91 [CI: 1.17–3.12], p=0.01; respectively). At multivariate analysis, for every 1-point increase in CFS score, the odds of mortality and the odds of major complications increased 1.72-fold and 1.41-fold, respectively. CONCLUSION: The increase in CFS is directly associated with an increased risk of mortality and major complications. The presence of severe frailty could effectively predict an increased risk of in-hospital death regardless of the treatment administered. The employment of CFS in elderly patients could help the identification of the need for closer monitoring and proper goals of care. |
format | Online Article Text |
id | pubmed-10579164 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-105791642023-10-18 The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) Laterza, Vito Covino, Marcello Schena, Carlo Alberto Russo, Andrea Salini, Sara Polla, Davide Della de’Angelis, Nicola Quero, Giuseppe Tondolo, Vincenzo La Greca, Antonio Merra, Giuseppe Sganga, Gabriele Gasbarrini, Antonio Franceschi, Francesco Landi, Francesco Alfieri, Sergio Rosa, Fausto J Gastrointest Surg Original Article BACKGROUND: SBO is a potentially life-threatening condition that often affects older patients. Frailty, more than age, is expected to play a crucial role in predicting SBO prognosis in this population. This study aims to define the influence of Clinical Frailty Scale (CFS) on mortality and major complications in patients ≥80 years with diagnosis of SBO at the emergency department (ED). METHODS: All patients aged ≥80 years admitted to our ED for SBO from January 2015 to September 2020 were enrolled. Frailty was assessed through the CFS, and then analyzed both as a continuous and a dichotomous variable. The endpoints were in-hospital mortality and major complications. RESULTS: A total of 424 patients were enrolled. Higher mortality (20.8% vs 8.6%, p<0.001), longer hospital stay (9 [range 5–14] days vs 7 [range 4–12] days, p=0.014), and higher rate of major complications (29.9% vs 17.9%, p=0.004) were associated with CFS ≥7. CFS score and bloodstream infection were the only independent prognostic factors for mortality (OR 1.72 [CI: 1.29–2.29], p<0.001; OR 4.69 [CI: 1.74–12.6], p=0.002, respectively). Furthermore, CFS score, male sex and surgery were predictive factors for major complications (OR 1.41 [CI: 1.13–1.75], p=0.002; OR 1.67 [CI: 1.03–2.71], p=0.038); OR 1.91 [CI: 1.17–3.12], p=0.01; respectively). At multivariate analysis, for every 1-point increase in CFS score, the odds of mortality and the odds of major complications increased 1.72-fold and 1.41-fold, respectively. CONCLUSION: The increase in CFS is directly associated with an increased risk of mortality and major complications. The presence of severe frailty could effectively predict an increased risk of in-hospital death regardless of the treatment administered. The employment of CFS in elderly patients could help the identification of the need for closer monitoring and proper goals of care. Springer US 2023-09-06 2023 /pmc/articles/PMC10579164/ /pubmed/37674098 http://dx.doi.org/10.1007/s11605-023-05820-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Laterza, Vito Covino, Marcello Schena, Carlo Alberto Russo, Andrea Salini, Sara Polla, Davide Della de’Angelis, Nicola Quero, Giuseppe Tondolo, Vincenzo La Greca, Antonio Merra, Giuseppe Sganga, Gabriele Gasbarrini, Antonio Franceschi, Francesco Landi, Francesco Alfieri, Sergio Rosa, Fausto The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title | The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title_full | The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title_fullStr | The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title_full_unstemmed | The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title_short | The Clinical Frailty Scale (CFS) as an Independent Prognostic Factor for Patients ≥80 Years with Small Bowel Obstruction (SBO) |
title_sort | clinical frailty scale (cfs) as an independent prognostic factor for patients ≥80 years with small bowel obstruction (sbo) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579164/ https://www.ncbi.nlm.nih.gov/pubmed/37674098 http://dx.doi.org/10.1007/s11605-023-05820-8 |
work_keys_str_mv | AT laterzavito theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT covinomarcello theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT schenacarloalberto theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT russoandrea theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT salinisara theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT polladavidedella theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT deangelisnicola theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT querogiuseppe theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT tondolovincenzo theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT lagrecaantonio theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT merragiuseppe theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT sgangagabriele theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT gasbarriniantonio theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT franceschifrancesco theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT landifrancesco theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT alfierisergio theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT rosafausto theclinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT laterzavito clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT covinomarcello clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT schenacarloalberto clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT russoandrea clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT salinisara clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT polladavidedella clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT deangelisnicola clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT querogiuseppe clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT tondolovincenzo clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT lagrecaantonio clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT merragiuseppe clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT sgangagabriele clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT gasbarriniantonio clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT franceschifrancesco clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT landifrancesco clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT alfierisergio clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo AT rosafausto clinicalfrailtyscalecfsasanindependentprognosticfactorforpatients80yearswithsmallbowelobstructionsbo |