衰弱对接受环咽肌功能障碍治疗患者手术结局的影响
Impact of Frailty on Surgical Outcomes in Patients Treated for Cricopharyngeus Muscle Dysfunction.
文献信息
| PMID | 42764578 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jessa Letargo |
| 作者单位 | Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 探讨接受环咽肌功能障碍（CPMD）手术患者的衰弱状态与手术结局之间的关系。
方法： 对在一家三级吞咽困难中心接受上食管括约肌（UES）干预的所有患者进行回顾性病历审查。收集人口学数据、衰弱指标、手术方式以及术前和术后进食评估工具-10（EAT-10）评分。采用改良衰弱指数-11（MFI-11）评估衰弱，将患者分为衰弱和非衰弱，主要结局为EAT-10变化。
结果： 共纳入130例患者（72%为女性；平均年龄73.9岁）。其中，61.5%有环咽肌（CP）横纹，38.5%有Zenker憩室（ZD）。根据MFI-11，16.9%被归类为衰弱，83.1%为非衰弱。非衰弱患者的平均ΔEAT-10评分（16.3，SD=12.0）显著高于衰弱患者（10.7，SD=11.0，p=0.047），表明其感知的吞咽改善更好。二次分析显示，非衰弱患者在ZD患者（ΔEAT-10 22.2 [SD=9.7]，p=0.159）和CP横纹患者（ΔEAT-10 12.0 [SD=11.7]，p=0.358）中结局更好。
结论： 衰弱是UES手术后吞咽结局的重要预测因素。两组均可见平均改善，但非衰弱患者获益更大。尽管如此，衰弱状态不应排除干预；将衰弱评估纳入术前评估可能改善CPMD管理中患者的选择和结局预期。
英文摘要
OBJECTIVE: To investigate the relationship between frailty status and surgical outcomes in patients undergoing procedures for cricopharyngeus muscle dysfunction (CPMD).
METHODS: Retrospective chart review of all patients who underwent upper esophageal sphincter (UES) interventions at a tertiary dysphagia center. Demographic data, frailty indicators, surgical procedure type, and pre- and postoperative Eating Assessment Tool-10 (EAT-10) scores were collected. Frailty was assessed using the Modified Frailty Index-11 (MFI-11), classifying patients as frail or nonfrail, with primary outcome EAT-10 change.
RESULTS: One hundred thirty patients were included (72% female; mean age 73.9 years). Of these, 61.5% had cricopharyngeus (CP) bars and 38.5% had Zenker's diverticulum (ZD). Based on MFI-11, 16.9% were classified as frail and 83.1% as nonfrail. Mean ΔEAT-10 scores were significantly greater in nonfrail patients (16.3, SD = 12.0) compared to frail patients (10.7, SD = 11.0, p = 0.047), indicating better perceived swallowing improvement. Secondary analysis showed nonfrail patients had better outcomes for patients with ZD (ΔEAT-10 22.2 [SD = 9.7], p = 0.159) and with CP bar (ΔEAT-10 12.0 [SD = 11.7], p = 0.358).
CONCLUSION: Frailty is a significant predictor of postoperative swallowing outcomes following UES surgery. Mean improvement was seen among both groups, but nonfrail patients derived greater benefit. Nonetheless, frailty status should not preclude intervention; incorporating frailty assessment into preoperative evaluation may improve patient selection and expectations for outcomes in CPMD management.