Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer: The role of the fragility index
Objective To evaluate the predictive value of obesity, comorbidities, and fragility on overall and severe complication rate and survival among patients surgically treated for endometrial cancer. Methods Consecutive patients with endometrial cancer treated at the Royal Infirmary Hospital of Edinburgh...
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| Veröffentlicht in: | International journal of gynecology and obstetrics 2020-02, Vol.148 (2), p.174-180 |
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| container_title | International journal of gynecology and obstetrics |
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| creator | Giannini, Andrea Di Donato, Violante Schiavi, Michele C. May, James Panici, Pierluigi Benedetti Congiu, Mario A. |
| description | Objective
To evaluate the predictive value of obesity, comorbidities, and fragility on overall and severe complication rate and survival among patients surgically treated for endometrial cancer.
Methods
Consecutive patients with endometrial cancer treated at the Royal Infirmary Hospital of Edinburgh from June 1, 2015, to June 30, 2017, were retrospectively enrolled in an observational study. Considering pre‐existing medical conditions, comorbidities, and complications, modified fragility index (mFI) was calculated. Logistic regression was used to evaluate predicting variables of overall (G1–G4) and severe (G3–G4) complication rate.
Results
One hundred patients were surgically treated for endometrial cancer. Elevated mFI >3 was related to a statistically higher access rate to the high dependency unit (HDU) or intensive care unit (ITU) (33.3% vs 6.6%, P=0.013). Overall, 31 women had postoperative complications. Using multivariate analysis, it was shown that undergoing laparotomy (odds ratio [OR] 7.06, 95% confidence interval [CI] 2.52–19.71; P3 (OR 7.19, 95% CI 1.43–36.25; P=0.021) were independent predictors of overall complications (G1–G4). Moreover, only smoking (OR 5.01, 95% CI 1.15–21.75; P=0.031) and mFI >3 (OR 5.16, 95% CI 1.07–24.94; P=0.047) were independent factors for severe complications (G3–G4).
Conclusion
Modified fragility index was an important predictor of complications among patients treated for endometrial cancer and could be a useful tool for assisting clinicians in perioperative management.
Modified fragility index >3 is an important predictor of overall and severe complications among patients treated for endometrial cancer. |
| doi_str_mv | 10.1002/ijgo.13020 |
| format | Article |
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To evaluate the predictive value of obesity, comorbidities, and fragility on overall and severe complication rate and survival among patients surgically treated for endometrial cancer.
Methods
Consecutive patients with endometrial cancer treated at the Royal Infirmary Hospital of Edinburgh from June 1, 2015, to June 30, 2017, were retrospectively enrolled in an observational study. Considering pre‐existing medical conditions, comorbidities, and complications, modified fragility index (mFI) was calculated. Logistic regression was used to evaluate predicting variables of overall (G1–G4) and severe (G3–G4) complication rate.
Results
One hundred patients were surgically treated for endometrial cancer. Elevated mFI >3 was related to a statistically higher access rate to the high dependency unit (HDU) or intensive care unit (ITU) (33.3% vs 6.6%, P=0.013). Overall, 31 women had postoperative complications. Using multivariate analysis, it was shown that undergoing laparotomy (odds ratio [OR] 7.06, 95% confidence interval [CI] 2.52–19.71; P<0.001) and having an mFI >3 (OR 7.19, 95% CI 1.43–36.25; P=0.021) were independent predictors of overall complications (G1–G4). Moreover, only smoking (OR 5.01, 95% CI 1.15–21.75; P=0.031) and mFI >3 (OR 5.16, 95% CI 1.07–24.94; P=0.047) were independent factors for severe complications (G3–G4).
Conclusion
Modified fragility index was an important predictor of complications among patients treated for endometrial cancer and could be a useful tool for assisting clinicians in perioperative management.
Modified fragility index >3 is an important predictor of overall and severe complications among patients treated for endometrial cancer.</description><identifier>ISSN: 0020-7292</identifier><identifier>EISSN: 1879-3479</identifier><identifier>DOI: 10.1002/ijgo.13020</identifier><identifier>PMID: 31657456</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Comorbidity ; Endometrial cancer ; Endometrial Neoplasms - complications ; Endometrial Neoplasms - surgery ; Female ; Fragility index ; Frailty - complications ; Frailty - epidemiology ; Humans ; Laparotomy - adverse effects ; Logistic Models ; Middle Aged ; Odds Ratio ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Period ; Predictor of complications ; Retrospective Studies ; Surgical Treatment ; Treatment Related Morbidity</subject><ispartof>International journal of gynecology and obstetrics, 2020-02, Vol.148 (2), p.174-180</ispartof><rights>2019 International Federation of Gynecology and Obstetrics</rights><rights>2019 International Federation of Gynecology and Obstetrics.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3290-433d0dbcc75d962f93125dc1868fc6c854e6a7cdf7b79cf406ea79130dbe863a3</citedby><cites>FETCH-LOGICAL-c3290-433d0dbcc75d962f93125dc1868fc6c854e6a7cdf7b79cf406ea79130dbe863a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijgo.13020$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijgo.13020$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31657456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giannini, Andrea</creatorcontrib><creatorcontrib>Di Donato, Violante</creatorcontrib><creatorcontrib>Schiavi, Michele C.</creatorcontrib><creatorcontrib>May, James</creatorcontrib><creatorcontrib>Panici, Pierluigi Benedetti</creatorcontrib><creatorcontrib>Congiu, Mario A.</creatorcontrib><title>Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer: The role of the fragility index</title><title>International journal of gynecology and obstetrics</title><addtitle>Int J Gynaecol Obstet</addtitle><description>Objective
To evaluate the predictive value of obesity, comorbidities, and fragility on overall and severe complication rate and survival among patients surgically treated for endometrial cancer.
Methods
Consecutive patients with endometrial cancer treated at the Royal Infirmary Hospital of Edinburgh from June 1, 2015, to June 30, 2017, were retrospectively enrolled in an observational study. Considering pre‐existing medical conditions, comorbidities, and complications, modified fragility index (mFI) was calculated. Logistic regression was used to evaluate predicting variables of overall (G1–G4) and severe (G3–G4) complication rate.
Results
One hundred patients were surgically treated for endometrial cancer. Elevated mFI >3 was related to a statistically higher access rate to the high dependency unit (HDU) or intensive care unit (ITU) (33.3% vs 6.6%, P=0.013). Overall, 31 women had postoperative complications. Using multivariate analysis, it was shown that undergoing laparotomy (odds ratio [OR] 7.06, 95% confidence interval [CI] 2.52–19.71; P<0.001) and having an mFI >3 (OR 7.19, 95% CI 1.43–36.25; P=0.021) were independent predictors of overall complications (G1–G4). Moreover, only smoking (OR 5.01, 95% CI 1.15–21.75; P=0.031) and mFI >3 (OR 5.16, 95% CI 1.07–24.94; P=0.047) were independent factors for severe complications (G3–G4).
Conclusion
Modified fragility index was an important predictor of complications among patients treated for endometrial cancer and could be a useful tool for assisting clinicians in perioperative management.
Modified fragility index >3 is an important predictor of overall and severe complications among patients treated for endometrial cancer.</description><subject>Aged</subject><subject>Comorbidity</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - complications</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Female</subject><subject>Fragility index</subject><subject>Frailty - complications</subject><subject>Frailty - epidemiology</subject><subject>Humans</subject><subject>Laparotomy - adverse effects</subject><subject>Logistic Models</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Period</subject><subject>Predictor of complications</subject><subject>Retrospective Studies</subject><subject>Surgical Treatment</subject><subject>Treatment Related Morbidity</subject><issn>0020-7292</issn><issn>1879-3479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOHDEQRa0oURhINnwA8jKK1MSPbrudXYQSHkKCBaxbHrs8GLnbje0hzEfwz3gYkiWrqvI9upYOQoeUHFNC2A9_v4rHlBNGPqAF7aVqeCvVR7SoIWkkU2wP7ed8TwihktLPaI9T0cm2Ewv0fJ3AelNiyjg6PMdc4gxJF_8IOD7WLQSsJ4sz1AOwieMcvKl5nDLWrkDCeZ1W9SngkkCXEaaCXUwYJhtHKMnXxOjJQPqJb-4Apxhg-1epu0t65YMvG-wnC09f0CenQ4avb_MA3f75fXNy1lxenZ6f_LpsDGeKNC3nltilMbKzSjCnOGWdNbQXvTPC9F0LQktjnVxKZVxLBGipqiG7hF5wzQ_Qt13vnOLDGnIZRp8NhKAniOs8ME5UT1vBuop-36EmxZwTuGFOftRpM1AybPUPW_3Dq_4KH731rpcj2P_oP98VoDvgrw-weadqOL84vdqVvgD5OZNn</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Giannini, Andrea</creator><creator>Di Donato, Violante</creator><creator>Schiavi, Michele C.</creator><creator>May, James</creator><creator>Panici, Pierluigi Benedetti</creator><creator>Congiu, Mario A.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202002</creationdate><title>Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer: The role of the fragility index</title><author>Giannini, Andrea ; Di Donato, Violante ; Schiavi, Michele C. ; May, James ; Panici, Pierluigi Benedetti ; Congiu, Mario A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3290-433d0dbcc75d962f93125dc1868fc6c854e6a7cdf7b79cf406ea79130dbe863a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Comorbidity</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - complications</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Female</topic><topic>Fragility index</topic><topic>Frailty - complications</topic><topic>Frailty - epidemiology</topic><topic>Humans</topic><topic>Laparotomy - adverse effects</topic><topic>Logistic Models</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Period</topic><topic>Predictor of complications</topic><topic>Retrospective Studies</topic><topic>Surgical Treatment</topic><topic>Treatment Related Morbidity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giannini, Andrea</creatorcontrib><creatorcontrib>Di Donato, Violante</creatorcontrib><creatorcontrib>Schiavi, Michele C.</creatorcontrib><creatorcontrib>May, James</creatorcontrib><creatorcontrib>Panici, Pierluigi Benedetti</creatorcontrib><creatorcontrib>Congiu, Mario A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giannini, Andrea</au><au>Di Donato, Violante</au><au>Schiavi, Michele C.</au><au>May, James</au><au>Panici, Pierluigi Benedetti</au><au>Congiu, Mario A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer: The role of the fragility index</atitle><jtitle>International journal of gynecology and obstetrics</jtitle><addtitle>Int J Gynaecol Obstet</addtitle><date>2020-02</date><risdate>2020</risdate><volume>148</volume><issue>2</issue><spage>174</spage><epage>180</epage><pages>174-180</pages><issn>0020-7292</issn><eissn>1879-3479</eissn><abstract>Objective
To evaluate the predictive value of obesity, comorbidities, and fragility on overall and severe complication rate and survival among patients surgically treated for endometrial cancer.
Methods
Consecutive patients with endometrial cancer treated at the Royal Infirmary Hospital of Edinburgh from June 1, 2015, to June 30, 2017, were retrospectively enrolled in an observational study. Considering pre‐existing medical conditions, comorbidities, and complications, modified fragility index (mFI) was calculated. Logistic regression was used to evaluate predicting variables of overall (G1–G4) and severe (G3–G4) complication rate.
Results
One hundred patients were surgically treated for endometrial cancer. Elevated mFI >3 was related to a statistically higher access rate to the high dependency unit (HDU) or intensive care unit (ITU) (33.3% vs 6.6%, P=0.013). Overall, 31 women had postoperative complications. Using multivariate analysis, it was shown that undergoing laparotomy (odds ratio [OR] 7.06, 95% confidence interval [CI] 2.52–19.71; P<0.001) and having an mFI >3 (OR 7.19, 95% CI 1.43–36.25; P=0.021) were independent predictors of overall complications (G1–G4). Moreover, only smoking (OR 5.01, 95% CI 1.15–21.75; P=0.031) and mFI >3 (OR 5.16, 95% CI 1.07–24.94; P=0.047) were independent factors for severe complications (G3–G4).
Conclusion
Modified fragility index was an important predictor of complications among patients treated for endometrial cancer and could be a useful tool for assisting clinicians in perioperative management.
Modified fragility index >3 is an important predictor of overall and severe complications among patients treated for endometrial cancer.</abstract><cop>United States</cop><pmid>31657456</pmid><doi>10.1002/ijgo.13020</doi><tpages>7</tpages></addata></record> |
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| ispartof | International journal of gynecology and obstetrics, 2020-02, Vol.148 (2), p.174-180 |
| issn | 0020-7292 1879-3479 |
| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Aged Comorbidity Endometrial cancer Endometrial Neoplasms - complications Endometrial Neoplasms - surgery Female Fragility index Frailty - complications Frailty - epidemiology Humans Laparotomy - adverse effects Logistic Models Middle Aged Odds Ratio Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Period Predictor of complications Retrospective Studies Surgical Treatment Treatment Related Morbidity |
| title | Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer: The role of the fragility index |
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