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已发表论文
预测老年腹部手术患者衰弱的列线图的开发与验证
Authors Zhang H, Xiao Y , Jin H, Wang X , Wang J
Received 9 June 2025
Accepted for publication 1 December 2025
Published 6 December 2025 Volume 2025:20 Pages 2423—2435
DOI https://doi.org/10.2147/CIA.S545803
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Nandu Goswami
Honghui Zhang,1,2 Yuting Xiao,2 Huimin Jin,3 Xiaohui Wang,2 Jing Wang1
1Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China; 2Department of Hepatobiliary Diseases, Hunan Provincial People’s Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, People’s Republic of China; 3Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410000, People’s Republic of China
Correspondence: Jing Wang, Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an, Shaanxi, 710061, People’s Republic of China, Tel +86 187 8940 0330, Email novowj@xjtu.edu.cn
Background: Frailty is a critical geriatric syndrome associated with adverse surgical outcomes, yet preoperative risk prediction models for older adults undergoing abdominal surgery remain underdeveloped. This study aimed to identify frailty risk factors and establish a predictive nomogram in this population.
Methods: We enrolled 790 older patients undergoing abdominal surgery at Hunan Provincial People’s Hospital from February 2022 to September 2022. Frailty was assessed using the Tilburg Frailty Index. Univariate analysis, LASSO regression and multivariate analysis were used in turn to identify independent risk factors for frailty. The nomogram was developed based on the independent risk factors. The sample was randomly divided into a test group (75%) and a validation group (25%). The area under the curve (AUC) of the receiver operating characteristic (ROC) was calculated to assess the predictive performance of the nomogram.
Results: The prevalence of frailty among older patients undergoing abdominal surgery was 74.18%. Eight independent risk factors were identified: advanced age (OR=1.32), lower BMI (OR=1.28), limited education (OR=1.45), laparoscopy (OR=1.67), tumor comorbidity (OR=2.01), diabetes (OR=1.89), antihyperlipidemic drug use (OR=1.53), and elevated interleukin-6 (OR=1.76). The nomogram demonstrated acceptable discrimination, with AUCs of 0.748 (the test group) and 0.707 (the validation group).
Conclusion: Our findings demonstrate a nomogram to predict the probability of frailty for older patients undergoing abdominal with acceptable predictive performance. The nomogram is helpful in guiding further targeted and effective intervention and prevention efforts to decrease frailty and improve health outcomes.
Keywords: frailty assessment, risk assessment tool, older adults, abdominal surgery, China
1Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, 710061, People’s Republic of China; 2Department of Hepatobiliary Diseases, Hunan Provincial People’s Hospital, The First-Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410005, People’s Republic of China; 3Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410000, People’s Republic of China
Correspondence: Jing Wang, Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76 Yanta West Road, Xi’an, Shaanxi, 710061, People’s Republic of China, Tel +86 187 8940 0330, Email novowj@xjtu.edu.cn
Background: Frailty is a critical geriatric syndrome associated with adverse surgical outcomes, yet preoperative risk prediction models for older adults undergoing abdominal surgery remain underdeveloped. This study aimed to identify frailty risk factors and establish a predictive nomogram in this population.
Methods: We enrolled 790 older patients undergoing abdominal surgery at Hunan Provincial People’s Hospital from February 2022 to September 2022. Frailty was assessed using the Tilburg Frailty Index. Univariate analysis, LASSO regression and multivariate analysis were used in turn to identify independent risk factors for frailty. The nomogram was developed based on the independent risk factors. The sample was randomly divided into a test group (75%) and a validation group (25%). The area under the curve (AUC) of the receiver operating characteristic (ROC) was calculated to assess the predictive performance of the nomogram.
Results: The prevalence of frailty among older patients undergoing abdominal surgery was 74.18%. Eight independent risk factors were identified: advanced age (OR=1.32), lower BMI (OR=1.28), limited education (OR=1.45), laparoscopy (OR=1.67), tumor comorbidity (OR=2.01), diabetes (OR=1.89), antihyperlipidemic drug use (OR=1.53), and elevated interleukin-6 (OR=1.76). The nomogram demonstrated acceptable discrimination, with AUCs of 0.748 (the test group) and 0.707 (the validation group).
Conclusion: Our findings demonstrate a nomogram to predict the probability of frailty for older patients undergoing abdominal with acceptable predictive performance. The nomogram is helpful in guiding further targeted and effective intervention and prevention efforts to decrease frailty and improve health outcomes.
Keywords: frailty assessment, risk assessment tool, older adults, abdominal surgery, China