医学
神经鞘瘤
前庭系统
多元分析
围手术期
人口统计学的
外科
病历
回顾性队列研究
临床终点
听神经瘤
内科学
随机对照试验
放射科
社会学
人口学
作者
Geoffrey C. Casazza,Matthew K. McIntyre,Richard K. Gurgel,Hilary C. McCrary,Clough Shelton,William T. Couldwell,Christian A. Bowers
出处
期刊:Otology & Neurotology
[Ovid Technologies (Wolters Kluwer)]
日期:2020-09-24
卷期号:41 (10): e1243-e1249
被引量:23
标识
DOI:10.1097/mao.0000000000002831
摘要
Objective: Understand the frailty of vestibular schwannoma surgical patients and how frailty impacts clinical course. Study Design: Retrospective Cohort. Setting: Single-tertiary academic hospital. Patients: All patients undergoing vestibular schwannoma surgery. Intervention: The modified frailty index (mFI) was calculated for all patients undergoing surgery for vestibular schwannoma between 2011 and 2018. Patient demographics and medical history, perioperative course, and postoperative complications were obtained from the medical record. Main Outcome Measures: The primary endpoint was hospital length of stay (LOS). Secondary endpoint was postoperative complications. Basic statistical analysis was performed including multivariate linear regressions to determine independent predictors of LOS. Results: There were 218 patients included and the mean age was 48.1 ± 0.9 (range 12–77). One-hundred ten patients were male (50.5%). The mean ICU LOS was 1.6 ± 0.1 days while mean total hospital LOS was 4.3 ± 0.2. There were 145 patients (66.5%) who were robust (nonfrail) with an mFI of 0, while 73 (33.5%) had an mFI of ≥1. Frailty (mFI≥2) was associated with longer hospital LOS compared with the prefrail ( p = 0.0014) and robust ( p = 0.0004) groups, but was not associated with increased complications (OR = 1.3; 95% CI: 0.5–3.7; p = 0.5925) or ICU LOS ( p > 0.05). In multivariate analysis, increased mFI, and NOT increased age, was an independent risk factor for increased hospital LOS ( p = 0.027). Conclusion: Increasing frailty, and not increasing age, is an independent risk factor for longer hospital LOS, but not for increased postoperative complications. Patients’ frailty status may be useful preoperatively in counselling patients about postoperative expectations and frail vestibular schwannoma patients may require increased health spending costs given their increased hospital LOS.
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