The Correlation Study Of Modified Frailty Index And Postoperative Complications Of Laparoscopic Cholecystectomy In Elderly Patients

Objective:To explore the correlation between the modified degeneration index and the postoperative complications of laparoscopic cholecystectomy in elderly patients with calculous cholecystitis.Methods:According to the inclusion and exclusion criteria of this study,collected from the Hospital Information System(HIS)medical record system from December 1,2017 to January 31,2020,was hospitalized in the general surgery department of Yanbian University Affiliated Hospital and underwent laparoscopy A total of 254 patients with acute calculous cholecystitis undergoing cholecystectomy were enrolled,with an average age of 69.72±7.19 years,and the ratio of male to female was 106/148.Collect basic personal information,personal history,frailty index items and outcome indicators to establish an improved frailty index.The modified frailty index is the total number of defective items,and the number of items is positively correlated with the degree of frailty.In this study,≥3 points are defined as frailty,<A score of 3 is defined as non-debilitating.According to this standard,71 cases were in the debilitating group and 183 cases in the non-debilitating group.RESULTS:1.Among the 254 patients enrolled,the frequency map of the degeneration index showed a gamma-like distribution,and 71 patients(28.0%)in the degeneration group.2.Among the 254 patients included,59 patients(23.2%)had complications;30 patients(11.8%)had pulmonary infections;10 patients(3.9%)had urinary tract infections;19 had hypoproteinemia.Cases(7.5%);26 cases(10.2%)with liver dysfunction;14 cases(5.5%)with poor wound healing;19 cases(7.5%)with electrolyte disturbance;13 cases(5.1%)with common bile duct injury;There were 4 cases(1.6%)of pressure ulcers;6 cases(2.4%)of respiratory failure;11 cases(4.3%)of heart failure.3.Asthenia is a risk factor for postoperative complications.Asthenia patients have a higher risk of complications than non-asthenia patients(OR=2.096;95%CI=1.099～3.996),including lung infections(OR=2.353;95%CI=1.049～5.282),hypoproteinemia(OR=4.303;95%CI=1.518～12.196),poor wound healing(OR=6.132;95%CI=1.694～22.198)and electrolyte disturbance(OR=3.232;95%CI=1.151～9.075).Conclusion:The modified degeneration index is an important indicator for predicting the occurrence of complications after laparoscopic cholecystectomy in elderly patients with acute calculous cholecystitis.