中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (1): 28-33.doi: 10.19438/j.cjoms.2026.01.005

• 论著 • 上一篇    下一篇

改良虚弱指数与老年颌面间隙感染患者术后不良结局的相关性分析

范晶娴, 吴嘉骏, 葛奎, 王繁麟   

  1. 上海交通大学医学院附属第九人民医院 急诊科,上海 200011
  • 收稿日期:2025-04-23 修回日期:2025-07-26 发布日期:2026-02-06
  • 通讯作者: 王繁麟,E-mail： 602639413@qq.com
  • 作者简介:范晶娴（1989-）,女,硕士,主治医师,E-mail: 501575634@qq.com
  • 基金资助:
    上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目（SHDC12023633）

Study on the correlation between modified frailty index and postoperative adverse outcomes in elderly patients with maxillofacial space infection

Fan Jingxian, Wu Jiajun, Ge Kui, Wang Fanlin   

  1. Department of Emergency, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2025-04-23 Revised:2025-07-26 Published:2026-02-06

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摘要： 目的: 探讨改良虚弱指数（modified frailty index,mFI）与老年颌面间隙感染患者全麻术后不良结局的关系,为临床风险评估提供参考。方法: 回顾性分析2016年6月—2025年1月上海交通大学医学院附属第九人民医院83例需全麻手术的老年颌面间隙感染患者的临床资料。采用11项mFI评估患者虚弱状态,分为虚弱组（mFI≥0.27,43 例）和非虚弱组（mFI<0.27,40 例）。通过单因素及多因素 logistic 回归分析 mFI 与术后并发症、住院时间（length of stay,LOS）的相关性,绘制受试者工作特征（receiver operator characteristic,ROC）曲线,评估mFI对LOS延长的预测效能。结果: 虚弱组术后新发肺炎（41.86%∶20.00%）、呼吸衰竭（19.05%∶2.56%）及心血管事件（48.84%∶23.08%）发生率显著高于非虚弱组（P<0.05）,且LOS更长（P<0.05）。多因素logistic回归分析显示,mFI≥0.27是LOS延长的独立危险因素（OR=2.53,95%CI：1.02~6.31）。ROC曲线分析显示,mFI联合APACHE-II评分对LOS延长的预测效能达到中等以上水平（AUC=0.772,95%CI：0.664~0.859）。结论: 改良虚弱指数可有效评估老年颌面间隙感染患者全麻术后不良结局风险,其联合 APACHE-II 评分对住院时间延长的预测价值较高,可为围术期诊疗决策提供依据。

关键词: 颌面间隙感染, 改良虚弱指数, 老年患者, 术后并发症, 住院时间

Abstract: PURPOSE: To explore the relationship between the modified frailty index(mFI) and adverse outcomes after general anesthesia in elderly patients with maxillofacial space infection, so as to provide a reference for clinical risk assessment. METHODS: The clinical data of 83 elderly patients with maxillofacial space infection who required general anesthesia surgery in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2016 to January 2025 were retrospectively analyzed. The 11-item mFI was used to assess the patients' frailty status, and they were divided into the frail group(mFI≥0.27, 43 cases) and the non-frail group(mFI<0.27, 40 cases). Univariate and multivariate logistic regression analyses were used to analyze the correlation between mFI and postoperative complications as well as length of stay(LOS). The receiver operator characteristic(ROC) curve was drawn to evaluate the predictive efficacy of mFI for prolonged LOS. RESULTS: The incidences of new-onset pneumonia (41.86% vs 20.00%), respiratory failure (19.05% vs 2.56%) and cardiovascular events (48.84% vs 23.08%) in the frail group were significantly higher than those in the non-frail group (P<0.05), and the LOS was longer(P<0.05). Multivariate logistic regression analysis showed that mFI ≥0.27 was an independent risk factor for prolonged LOS(OR=2.53, 95%CI: 1.02-6.31). ROC curve analysis showed that the predictive efficacy of mFI combined with APACHE-II score for prolonged LOS reached above the moderate level(AUC=0.772, 95%CI: 0.664-0.859). CONCLUSIONS: The modified frailty index can effectively assess the risk of adverse outcomes after general anesthesia in elderly patients with maxillofacial space infection. Its combination with APACHE-II score has high predictive value for prolonged hospital stay, which can provide a basis for perioperative diagnosis and treatment decisions.

Key words: Maxillofacial space infection, Modified frailty index, Elderly patients, Postoperative complications, Length of stay

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