A retrospective study on the relationship between 5 modified frailty index (5-mFI) and postoperative complications of gynecological elderly patients undergoing abdominal surgery

Ma, Hai-Rui; Liu, Jiang; Li, Si-xun; X, Guo; Zhang, Yunfeng; Lin, Jing-yan

doi:10.1186/s12871-023-02089-x

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…A cut-point of ≥ 2 indicates frailty. This instrument has been cross-culturally adapted and fully validated in Chinese population [ 28 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

Xiong,

Zhang,

Chen

et al. 2024

BMC Surg

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Background To determine whether frailty can predict prolonged postoperative ileus (PPOI) in older abdominal surgical patients; and to compare predictive ability of the FRAIL scale, the five-point modified frailty index (mFI-5) and Groningen Frailty Indicator (GFI) for PPOI. Methods Patients (aged ≥ 65 years) undergoing major abdominal surgery at our institution between April 2022 to January 2023 were prospectively enrolled. Frailty was evaluated with FRAIL, mFI-5 and GFI before operation. Data on demographics, comorbidities, perioperative management, postoperative recovery of bowel function and PPOI occurrence were collected. Results The incidence of frailty assessed with FRAIL, mFI-5 and GFI was 18.2%, 38.4% and 32.5% in a total of 203 patients, respectively. Ninety-five (46.8%) patients experienced PPOI. Time to first soft diet intake was longer in patients with frailty assessed by the three scales than that in patients without frailty. Frailty diagnosed by mFI-5 [Odds ratio (OR) 3.230, 95% confidence interval (CI) 1.572–6.638, P = 0.001] or GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) was related to a higher risk of PPOI. Both mFI-5 [Area under curve (AUC) 0.653, 95% CI 0.577–0.730] and GFI (OR 2.627, 95% CI 1.307–5.281, P = 0.007) had insufficient accuracy for the prediction of PPOI in patients undergoing major abdominal surgery. Conclusions Elderly patients diagnosed as frail on the mFI-5 or GFI are at an increased risk of PPOI after major abdominal surgery. However, neither mFI-5 nor GFI can accurately identify individuals who will develop PPOI. Trial registration This study was registered in Chinese Clinical Trial Registry (No. ChiCTR2200058178). The date of first registration, 31/03/2022, https://www.chictr.org.cn/.

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“…A cut-point of ≥ 2 indicates frailty. This instrument has been cross-culturally adapted and fully validated in Chinese population [ 28 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

Xiong,

Zhang,

Chen

et al. 2024

BMC Surg

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The association between frailty and ageing: Results from an observational study including 9497 elderly patients

Jensen,

Lundstrøm,

Kowark

et al. 2023

Acta Anaesthesiol Scand

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BackgroundElderly surgical patients have a high risk of postoperative complications. However, patients exhibit considerable diversity in health and functional status; thus, identifying the fragile may be necessary when selecting surgical candidates. We aimed to compare the prevalence of frailty in patients ≥90 years with patients aged 80–89. Second, we assessed the association between frailty and all‐cause 30‐day mortality.MethodsWe performed a planned secondary analysis of the peri‐interventional outcome study in the elderly (POSE), including 9497 patients (≥80 years) undergoing any surgical and nonsurgical procedures in 177 European centres from October 2017 to December 2018. The primary outcome assessment included frailty as a binary variable, and data were analysed using Fisher's exact test/Chi‐squared test. The association between frailty and all‐cause 30‐day mortality was analysed using a multivariate logistic regression model adjusted for age, sex, surgical urgency, orthopaedic urgency, and surgical severity.ResultsIn total, 999 of 9497 (10.5%) patients were 90 years or above. Among patients ≥90 years, 274 (27.4%) were frail compared to 1062 (12.5%) of patients aged 80–89 (odds ratio (OR): 2.6; 95% CI 2.3–3.1). Frailty was associated with increased 30‐day mortality in both the unadjusted (crude OR 6.3; 5.1–7.7) and adjusted analysis (OR 4.5; 3.6–5.7). In the adjusted analysis, age ≥90 was not associated with 30‐day mortality.ConclusionWe found a high frequency of frailty in patients aged 90 years or above compared with patients aged 80–89. In addition, frailty was associated with an increased risk of 30‐day mortality. Surprisingly, age was not a significant risk factor in the adjusted mortality analysis.

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Development and validation of a risk prediction model for severe postoperative complications in elderly patients with hip fracture

Wei,

Jiang,

Zhang

et al. 2024

PLoS ONE

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Objective This study aimed to investigate risk factors associated with severe postoperative complications following hip fracture surgery in elderly patients and to develop a nomogram-based risk prediction model for these complications. Methods A total of 627 elderly patients with hip fractures treated at Yongchuan Hospital of Chongqing Medical University from January 2015 to April 2024 were collected. 439 patients were assigned to the training cohort for model development, and 188 to the validation cohort for model assessment. The training cohort was stratified based on the presence or absence of severe complications. We employed LASSO regression, as well as univariate and multivariate logistic regression analyses, to identify significant factors. A nomogram was constructed based on the outcomes of the multivariate regression. The model’s discriminative ability was assessed using the area under the receiver operating characteristic curve (AUC), while calibration plots and decision curve analysis (DCA) evaluated its calibration and stability. Internal validation was performed using the validation cohort. Results Out of the 627 patients, 118 (18.82%) experienced severe postoperative complications. Both LASSO regression and multivariate logistic analysis identified the modified 5-item frailty index (mFI-5) and the preoperative C-reactive protein to albumin ratio (CAR) as significant predictors of severe complications. The nomogram model, derived from the multivariate analysis, exhibited strong discriminative ability, with an AUC of 0.963 (95% CI: 0.946–0.980) for the training cohort and 0.963 (95% CI: 0.938–0.988) for the validation cohort. Calibration plots demonstrated excellent agreement between the nomogram’s predictions and actual outcomes. Decision curve analysis (DCA) indicated that the model provided clinical utility across all patient scenarios. These findings were consistent in the validation cohort. Conclusions Both the mFI-5 and CAR are predictive factors for severe postoperative complications in elderly patients undergoing hip fracture surgery.

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A retrospective study on the relationship between 5 modified frailty index (5-mFI) and postoperative complications of gynecological elderly patients undergoing abdominal surgery

Cited by 3 publications

References 28 publications

Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

Comparison of three frailty scales for prediction of prolonged postoperative ileus following major abdominal surgery in elderly patients: a prospective cohort study

The association between frailty and ageing: Results from an observational study including 9497 elderly patients

Development and validation of a risk prediction model for severe postoperative complications in elderly patients with hip fracture

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