Outcome Analysis Using the Modified Frailty Index-5 in Patients With Complex Aortoiliac Disease

• Tipo: Artigo em Revista Científica Internacional
• Data: 2022

Autores

Nobrega, L (Autor) Outra; Pereira Neves, A (Autor) FMUP; Duarte Gamas, L (Autor) Outra; Dias, PP (Autor) Outra; Azevedo Cerqueira, A (Autor) Outra; Ribeiro, H (Autor) Outra; Vidoedo, J (Autor) Outra; Teixeira, J (Autor) Outra; Rocha Neves, J (Autor) FMUP

Revista

Título: Annals of Vascular Surgery

Vol. 79

Páginas: 153-161

ISSN: 0890-5096

Editora: Elsevier

Indexação

ISI Web of Knowledge - 7 Citações

Scopus - 7 Citações

Outras Informações

ID Authenticus: P-00V-H9W

DOI: 10.1016/j.avsg.2021.06.049

Abstract (EN): OBJECTIVES: Vascular surgery patients commonly have several comorbidities that cumulatively lead to a frailty status. The cumulative comorbidities disproportionately increase the risk of adverse events and are also associated with worsened long-term prognosis. In recent years, several tools have been elaborated with the objective of quantifying a patient's frailty. One of them is the modified frailty index-5 (mFl-5), a simplified and easy to use index. There is scarce data regarding its value as a prognostic factor in aortoiliac occlusive disease. The aim of this work is to validate mFl-5 as a potential postoperative prognostic indicator in this population. METHODS: From January 2013 to January 2020, 109 patients who underwent elective revascularizations, either endovascular or open surgery, having Trans-Atlantic Inter-Society Consensus II type D aortoiliac lesions in a tertiary and a regional hospital were selected from a prospective vascular registry. Demographic data was collected including diabetes mellitus, chronic heart failure, chronic obstructive pulmonary disease, arterial hypertension requiring medication and functional status. The 30-d and subsequent long-term surveillance outcomes were also collected including major adverse cardiovascular events (MACE), major adverse limb events (MALE) and all-cause mortality were assessed in the 30-d post-procedure and in the subsequent long-term surveillance period. The mFl-5 was applied to this population to evaluate the prognostic impact of this frailty marker on mortality and morbidity. RESULTS: In the long-term follow-up, mFl-5 was significantly associated with MACE (hazard ratio [HR] 2.469; 95% confidence interval [CI]: 1.267-4.811; P = .008) and all-cause mortality (HR 2.585; 95% CI: 1.270-5.260; P = .009). However, there was no significant association with 30-day outcomes. Along with the presence of chronic kidney disease, mFl-5 was the prognostic factor better able of predicting MACE. No prognostic value was found regarding short-term outcomes. CONCLUSION: The mFl-5 index may have a role in predicting long term outcomes, namely MACE and all-cause mortality, in the subset of patients with extensive aortoiliac occlusive disease. Its ease of use can foster its application in risk stratification and contribute for the decision-making process.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9