Preoperative frailty predicts postoperative outcomes in intestinal-cutaneous fistula repair.


BACKGROUND:The outcomes of operative repair of intestinal-cutaneous fistulas vary widely throughout the literature. We aimed to investigate whether the modified frailty index-5 is a reliable tool to account for physiologic reserve and whether it serves as a predictor of Clavien-Dindo grade IV complications in those with intestinal-cutaneous fistulas undergoing operative repair. METHODS:We queried the American College of Surgeons National Surgical Quality Improvement Program 2006 to 2017 database to include patients who underwent intestinal-cutaneous fistulas repair. The outcome of interest was 30-day Clavien-Dindo grade IV complications. The incidence of 30-day post-operative Clavien-Dindo grade IV complications were evaluated based on calculated modified frailty index-5 score. Multivariable logistic regression analyses were performed to assess the association of Clavien-Dindo grade IV complications and modified frailty index-5. RESULTS:A total of 3,995 patients were identified who underwent an intestinal-cutaneous fistulas repair. The median age (interquartile range) was 57 years (46, 67), and most patients were female (2,143 [53.7%]), White (3,206 [80.3%]), and 1,512 (38.2%) were obese. After adjusting for relevant covariates such as demographics, comorbidities, and operative details, modified frailty index-5 was independently associated with Clavien-Dindo grade IV complications (odds ratio = 2.81, 95% confidence interval 1.64-4.82; P < .001). CONCLUSION:Modified frailty index-5 is an independent predictor of Clavien-Dindo grade IV complications following intestinal-cutaneous fistulas repair. It can be used to account for physiologic reserve, thus reducing the variability of outcomes reported for intestinal-cutaneous fistulas repair.






Alser O,Naar L,Christensen MA,Saillant N,Parks J,Mendoza A,Fagenholz P,King D,Kaafarani HMA,Velmahos GC,Fawley J




Has Abstract


2021-01-04 00:00:00










  • Telomerase activity in the differential diagnosis of papillary carcinoma of the thyroid.

    abstract:BACKGROUND:Although fine-needle aspiration (FNA) is 90% sensitive in the detection of papillary carcinoma (PC) of the thyroid, its specificity has been reported as low as 52%. Consequently, patients who have an FNA suspicious for PC may undergo operation for a benign process. The ribonucleoprotein telomerase has been n...


    pub_type: 杂志文章


    authors: Saji M,Westra WH,Chen H,Umbricht CB,Tuttle RM,Box MF,Udelsman R,Sukumar S,Zeiger MA

    更新日期:1997-12-01 00:00:00

  • Differentiation of precursors into parathyroid-like cells for treatment of hypoparathyroidism.

    abstract:BACKGROUND:Hypoparathyroidism is the most frequent permanent complication of thyroid surgery. Our hypothesis is that human precursor cells in culture can be differentiated into parathyroid cells and used to reconstitute function. Human embryonic stem cells (hESCs) are a stable model to study differentiation into parath...


    pub_type: 杂志文章


    authors: Woods Ignatoski KM,Bingham EL,Frome LK,Doherty GM

    更新日期:2010-12-01 00:00:00

  • Appendectomy and subsequent risk of inflammatory bowel diseases.

    abstract:BACKGROUND:Case-control studies have reported an inverse relationship between appendectomy and the risk of ulcerative colitis, but the association has not been confirmed in prospective studies. METHODS:Using national hospital discharge registry data in Denmark, the authors followed up 154,434 patients who underwent ap...


    pub_type: 杂志文章,meta分析


    authors: Frisch M,Johansen C,Mellemkjaer L,Engels EA,Gridley G,Biggar RJ,Olsen JH

    更新日期:2001-07-01 00:00:00

  • Parathyroidectomy is underused in patients with tertiary hyperparathyroidism after renal transplantation.

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    pub_type: 杂志文章


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    pub_type: 临床试验,杂志文章


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  • Acute cyclosporine-induced renal vasoconstriction is mediated by endothelin-1.

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    pub_type: 杂志文章


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    更新日期:1993-08-01 00:00:00

  • Evolution of the surgical approach for replacement of degenerated mitral bioprostheses.

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    pub_type: 杂志文章,评审


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  • Cetuximab therapy in head and neck cancer: immune modulation with interleukin-12 and other natural killer cell-activating cytokines.

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    更新日期:2000-02-01 00:00:00

  • An experimental assessment of the effect of blood transfusion on susceptibility to bacterial infection.

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  • Early postburn lipid peroxidation: effect of ibuprofen and allopurinol.

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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    更新日期:2019-07-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:1996-06-01 00:00:00

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    pub_type: 杂志文章


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    pub_type: 杂志文章


    authors: Shamberger RC,Holzman RS,Griscom NT,Tarbell NJ,Weinstein HJ,Wohl ME

    更新日期:1995-09-01 00:00:00

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    pub_type: 杂志文章


    authors: Godfrey M,Rosser AA,Pugh CM,Shaffer DW,Sachdeva AK,Jung SA

    更新日期:2019-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Gelin J,Rehfeld JF,Jansson R,Svanvik J

    更新日期:1987-02-01 00:00:00

  • Improving predictive value of complementary tests in carotid artery disease.

    abstract::In a prospective study the accuracy of B-mode ultrasound imaging alone was compared with its use in conjunction with bidirectional Doppler ultrasound, carotid phonoangiography, and oculoplethysmography to independently assess contrast arteriograms of carotid arteries studied for presumed extracranial vascular disease....


    pub_type: 杂志文章


    authors: Kerstein MD

    更新日期:1983-01-01 00:00:00