| Objective: The aim of this study was to verify the feasibility and validity of the Frailty Assessment Scale for Elderly Patients with Inguinal Hernia proposed by the Hernia and Abdominal Wall Surgery Group of the Chinese Society of Medical Surgery in the Chinese Expert Consensus on the Diagnosis and Treatment of Inguinal Hernia in the Elderly(2019 edition),to analyze its application value,and to provide a reference for further improvement of the scale by evaluating its reliability and validity.Methods: In this study,the frailty assessment scale for elderly inguinal hernia patients was applied to the elderly population and elderly inguinal hernia patients to examine the basic reliability of the scale,including feasibility,internal consistency reliability,retest reliability,content validity,discriminant validity and structural validity,and to test the5-item modified frailty index(5-m FI)to examine the validity and predictive validity of the frailty assessment scale in elderly patients with inguinal hernia,to explore the optimal threshold value of this scale for frailty diagnosis,to revise the frailty classification based on this threshold value,and to analyze the predictive validity of this scale on the occurrence of acute urinary retention,delirium,poor incision healing,seroma hematoma in the operative area,chronic pain,and the occurrence of postoperative complications in elderly patients with inguinal hernia.Results: In the elderly population,the completion rate of the Frailty Assessment Scale for Elderly Patients with Inguinal Hernia was 99.08%,the overall Cronbach’s αcoefficient of the scale was 0.889,the retest reliability coefficient was 0.925,the content validity was 1.000,the overall concordance content validity was 1,the results of the chi-square test for the high and low age groups showed good discrimination,the KMO test of the scale(Kaiser-Meyer-Olkin,KMO)values were greater than 0.6,and Bartlett’s test(Bartlett’s spherical test)results showed statistically significant differences(P <0.001),indicating that the feasibility,internal consistency reliability,retest reliability,content validity,and structural validity of the debilitating assessment scale for elderly patients with inguinal hernia.discriminant validity and structural validity were better.In elderly patients with inguinal hernia,the area under the curve(AUC)was 0.806 using the5-m FI as the gold standard,indicating good validity of the frailty assessment scale in elderly patients with inguinal hernia.The optimal threshold value for diagnosing debilitation was also calculated to be 18,and the score 17 to 18 were determined to be mildly debilitating,14～16 to be moderately debilitating,and 0～13 to be severely debilitating.The predictive validity of the AUC for postoperative acute urinary retention was 0.763,with a critical value of 14.5,which was better than 5-m FI;the predictive validity of the AUC for postoperative hematoma seroma was 0.775,with a critical value of 16.5,which was better than 5-m FI;the predictive validity of the AUC for postoperative delirium was 0.818,with a critical value of 19.5,which was better than5-m FI,The predictive validity of AUC for poor incision healing was 0.550,with a critical value of 16.5,which was poor compared with 5-m FI;the predictive validity of AUC for postoperative chronic pain was 0.507,with a critical value of 5.5,which was poor compared with 5-m FI;the predictive validity of AUC for postoperative complications was 0.643,with a critical value of 16.5,which was poor compared with5-m FI;the predictive validity of AUC for postoperative complications was 0.643,with a critical value of 16.5,which was poor compared with 5-m FI.The critical value was 16.5,which was better than 5-m FI.Conclusion: This study demonstrated that the Frailty Assessment Scale for Elderly Patients with Inguinal Hernia has good reliability,high feasibility and validity,and high application value,and is suitable for preoperative assessment of the degree of frailty in elderly patients with inguinal hernia. |
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