Research On The Correlation Between Modified Frailty Index And Postoperative Complications Of Spontaneous Cerebral Hemorrhage In Elderly Patients

Objective:In this study,the clinical information of patients was extracted by case system,and then established the modified frailty index(mFI),and explored the effect of frailty condition on the short-term complications of elderly patients with spontaneous cerebral hemorrhage.The aim is to provide an important reference for perioperative comprehensive intervention and prognosis evaluation in elderly patients with spontaneous cerebral hemorrhage.Methods:Strictly according to the inclusion and exclusion criteria of this study,a total of 148 cases of spontaneous cerebral hemorrhage in neurosurgery in the First Affiliated Hospital of Chengdu Medical College from August 2014 to July 2018 were collected from the case system.We collected the gender,age,marital status,smoking history,drinking history,chronic disease,Glasgow coma score,ASA score,length of hospital stay,operation time,postoperative complications and hospitalization expenses from the case system.And established an Excel data extraction table for perioperative period of spontaneous cerebral hemorrhage in the elderly,and calculated the mFI,it is equal to the sum of all points.The larger the value indicates that the elderly patients with spontaneous cerebral hemorrhage are frailer,that is,there are more health defects.In this study,frailty was defined as mFI?3 points,and non-frail was defined as mFI< 3points.Univariate analysis and multivariate Logistic regression analysis were used to analyze the effect of frailty on short-term complications of elderly patients with spontaneous cerebral hemorrhage.Results:A total of 148 elderly patients with spontaneous cerebral hemorrhage were included,including 36(24.3%)in the frail group and 112(75.7%)in the non-frail group.The age range is 60-94 years old and the average age is 68.47±6.371 years old.There were 91 males(61.5%)and 57 females(38.5%).Compared non-frail group with the frail group,the urinary tract infection rate was 8.0% and 22.2%,the lung infection ratewas 30.4% and 58.3%,the incidence of electrolyte imbalance was 75% and 94.4%,the incidence of hypoproteinemia was 28.6% and 47.2%,respectively.Through univariate analysis,the incidence of urinary tract infection,pulmonary infection,electrolyte imbalance and hypoproteinemia were statistically significant in elderly patients with spontaneous cerebral hemorrhage in frail and non-frail group(P<0.05).After logistic regression analysis,corrected the confounding factors of gender,age,marital status,drinking,smoking,showed that the frail group was more prone to urinary tract infection(OR: 3.678;95% CI: 1.163-11.631),pulmonary infection(OR: 4.054;95% CI:1.737-9.457),electrolyte disturbance(OR: 6.236;95% CI: 1.348-28.851),hypoproteinemia(OR: 2.450;95% CI: 1.085-5.530).Conclusions:The incidence of postoperative complications is higher in elderly patients with spontaneous cerebral hemorrhage.The modified frailty index is significantly associated with postoperative adverse outcomes in elderly patients with spontaneous cerebral hemorrhage,including pulmonary infection,urinary tract infection,electrolyte disturbance and hypoproteinemia.