Modified Frailty Index Can Be Used to Predict Adverse Outcomes and Mortality after Lower Extremity Bypass Surgery

The Impact of Frailty on Outcomes of Elderly Patients After Major Vascular Surgery: A Systematic Review and Meta-analysis

“…1). Seven multi-domain tools were adopted in 12 studies to assess frailty status before vascular procedures: the Groningen Frailty Indicator (GFI), 8 Edmonton Frail Scale (EFS), 31 modified Frailty Index (mFI), 13,14,26,29,30 Barthel Index (BI), 15 Addenbrooke's Vascular Frailty Score (AVFS), 28 Ruptured Aneurysm Frailty Score (RAFS), 27…”

“…35 Six studies were conducted in patients who underwent major vascular surgery, 7,8,28,30,31,34 nine studies in patients with AAA, 11,12,14,27,33,36e39 and 10 studies in patients with LEAD. 10,13,15,25,26,29,32,33,35,40 The basic characteristics of the included studies are given in Table 1.…”

Deficit Accumulation and Phenotype Assessments of Frailty Both Poorly Predict Duration of Hospitalization and Serious Complications after Noncardiac Surgery

“…Our sensitivity analysis, evaluating the relationship between frailty and absolute length of hospitalization without accounting for type of surgery, also revealed a prediction error greater than 2 days for both indices. Many investigators report significant associations between measures of frailty and postoperative complications, 1,5,6,8,16,19,20,29,[36][37][38][39][40] but only some report C statistics, 6,29,30,33,36,37,39 which quantify clinical importance. Reported C statistics range from 0.53 to 0.68, with most being between 0.60 and 0.65, 6,29,30,39 which are similar to our findings.…”

“…18 Both the Modified Frailty Index and the Hopkins Frailty Score predict adverse outcomes after surgery. 1,5,[18][19][20][21][22] It is unclear, however, which paradigm of frailty assessment better assesses perioperative risk. Because there is no gold standard to validate these frailty assessment tools, comparison of their abilities to predict adverse postoperative outcomes would be most useful.…”

“…[1][2][3][4] The reported incidence of frailty among patients presenting for noncardiac surgery ranges from 2 to 13%, depending on the frailty assessment tool used and definition thresholds. 5,6 The incidence of frailty is substantial in high-risk populations, including patients having emergency surgery (26%) 7 and elderly patients having major orthopedic surgery (41%). 8 Initially, frailty measurement tools were constructed to predict mortality and other adverse events such as falls,…”