Abstract:

Objective To explore the effects of frailty assessment and American Society of Anesthesiologists （ASA） physical classification on predicting postoperative complications among elderly patients.Methods General information,frailty status,ASA physical classification and incidence of complications were collected in 245 elderly patients in a tertiary hospital. The receiver operating characteristic （ROC） was used to evaluate the predictive ability of frailty assessment,ASA physical classification,and their combination.Results The area under the curve（AUC） in prediction of complications using combination of frailty assessment and ASA physical classification was 0.858 and significantly higher than individually using ASA physical classification（0.751） and frailty assessment（0.762）（P<0.001）. The sensitivity of combination was 90.48% and the specificity was 63.74%.Conclusion Frailty assessment combined with ASA physical classification can effectively predict the occurrence of postoperative complication. Frailty assessment evaluated by nurses can provide basis for perioperative safety management in elderly patients.

Key words: Frailty, Anesthesia, Elderly, Postoperative Complication, Forecasting

摘要：

【目的】探讨衰弱评估联合麻醉分级对老年患者术后并发症的预测作用。【方法】收集某三级甲等医院245例老年外科手术患者的一般资料、衰弱状态、麻醉分级,以及住院期间并发症发生的资料。通过受试者工作特征（receiver operating characteristic,ROC）曲线,评价衰弱评估、麻醉分级及两者联合对老年患者术后并发症的预测作用。【结果】衰弱评估联合麻醉分级预测老年患者术后并发症发生的ROC曲线下面积为0.858,显著高于单独应用麻醉分级、衰弱评估的0.751、0.762（P<0.001）;联合应用的敏感度和特异度分别为90.48%和63.74%。【结论】衰弱评估联合麻醉分级能有效预测老年患者术后并发症的发生,由护士进行衰弱评估能辅助临床医师术前决策,为老年患者围手术期安全管理提供依据。

关键词: 衰弱, 麻醉, 老年人, 手术后并发症, 预测