Modified Frailty Index Is an Effective Risk Assessment Tool in Primary Total Knee Arthroplasty

Bellamy, Jaime L.; Runner, Robert P.; Vu, CatPhuong Cathy L.; Schenker, Mara L.; Bradbury, Thomas L.; Roberson, James R.

doi:10.1016/j.arth.2017.03.046

Cited by 96 publications

(73 citation statements)

References 23 publications

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“…Although the number of reports on patient-related outcome measures in vascular surgery is limited, studies in other surgical populations support our findings. The association between frailty and discharge to a care facility reported in this review corresponds with results from studies in patients undergoing thoracic aortic surgery, 33 orthopedic surgery, 34 trauma surgery, 35 and urologic surgery. 36 Studies included in this review reported several others factors that were associated with nonhome discharge, including comorbidity, increasing age, and occurrence of postoperative complications.…”

Section: Frailty and Functional Outcomes In Other Surgical Populationssupporting

confidence: 78%

Frailty and functional outcomes after open and endovascular procedures for patients with peripheral arterial disease: A systematic review

Aalst

Verwijmeren

Dongen

et al. 2020

Journal of Vascular Surgery

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Background: Frailty has been associated with postoperative complications and mortality across surgical specialties, including vascular surgery. However, the influence of frailty on postoperative functional outcomes is unclear. We sought to determine the influence of frailty on functional outcomes after open or endovascular vascular procedures in patients with peripheral arterial disease. Methods: This systematic review was conducted according to the PRISMA guidelines. Eligible articles were identified through database searches of Pubmed and EMBASE in April 2017. Studies reporting on frailty and functional outcomes after vascular interventions for peripheral artery disease (PAD) were included. Outcomes of interest were dependency in activities of daily living (ADL), dependent mobility, discharge destination, disability-free survival, and quality of life. Individual studies were assessed for quality and risk of bias using the Quality in Prognosis Studies tool. Results: Eight studies met the eligibility criteria and were included. The risk of bias was low in two studies, intermediate in three studies, and high in three studies. Methods for frailty assessment were different for each study. Frailty was a predictor for discharge to a higher level of care, dependent mobility, and dependency in ADL after vascular procedures for PAD. Both frailty models and individual frailty characteristics seem to be associated with these adverse functional outcomes. Conclusions: Despite a limited amount of literature and an overall intermediate quality of the included studies, this systematic review shows an association between frailty and adverse functional outcomes after peripheral arterial procedures for PAD, including discharge to a care facility, dependent mobility, and a decline in ADL functioning.

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Section: Frailty and Functional Outcomes In Other Surgical Populationssupporting

confidence: 78%

Frailty and functional outcomes after open and endovascular procedures for patients with peripheral arterial disease: A systematic review

Aalst

Verwijmeren

Dongen

et al. 2020

Journal of Vascular Surgery

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“…The 11-item mFI has also been widely used in non-spinal surgeries, such as head and neck surgery, 15 elective abdominal aortic aneurysm repair, 16 lobectomy, 17 curative surgery for urologic malignancy, 18 primary total hip arthroplasty 19 and primary total knee arthroplasty. 20 The prevalence of frailty varies as a function of the method used to measure frailty, the study population, and the threshold used to classify an individual as frail. Our findings demonstrate that frailty is present in approximately 15.5% of the elective posterior thoracolumbar Figure 3 The length of stay after elective posterior thoracolumbar fusion surgery increased as the mFI score increased.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…13 This list has been simplified into the Modified Frailty Index (mFI), which is based on 11 co-morbidities and functional status obtained from the patient's chart to stratify risk and predict adverse events in multiple surgical specialties. 9,10,[14][15][16][17][18][19][20][21][22][23][24] Frailty has long been recognized as a clinical syndrome that may serve as a tool to predict mortality and adverse events (AEs). Indeed, the effect of frailty on elective thoracolumbar surgery outcomes is still under discussion.…”

Section: Introductionmentioning

confidence: 99%

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<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

Sun¹,

Lu²,

Kong³

et al. 2020

CIA

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Background and Aim: Frailty is an independent predictor of mortality and adverse events (AEs) in patients undergoing surgery. This study aimed to quantify the ability of Modified Frailty Index (mFI) to predict AEs in older patients undergoing elective posterior thoracolumbar fusion surgery. Methods: We retrospectively reviewed the results of 426 patients with the following diagnoses and follow-up evaluations of at least 12 months duration: lumbar disc herniation, 125; degenerative spondylolisthesis, 81; lumbar spinal canal stenosis, 187; and adult spinal deformities, 33. The cases were divided into two groups. The long spinal fusion (LSF) group was defined as ≥3 spinal levels with segmental pedicle-screw fixation. Short spinal fusion (SSF) were defined with at most two levels. The mFI used in the present study is an 11variable assessment. The association of frailty with AEs was determined after adjusting for known and suspected confounders. Results: Frailty was presented in 66 patients (15.5%) within the total population (LSF, 21.9% and SSF, 11.8%). Rates of AEs assessed in the study increased stepwise with an increase in the mFI for the two groups. The severity of frailty was an independent predictor of any, major, and minor complications in the LSF group and any, minor complication in the SSF group (P<0.05). A comparison of post-operative clinical outcomes showed that the ODI and SF-36 scores deteriorated as the mFI increased. Conclusion: Frailty was shown to be an independent predictor of AEs in older patients undergoing elective posterior thoracolumbar fusion surgery, especially for patients undergoing LSF.

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“…A high frailty score was associated in this study with increased risk of mortality and adverse outcomes. Since the original publication, the frailty score has been extensively studied in adults and has been found to be associated with adverse outcomes in a heterogeneous array of medical conditions such as liver [40] and renal disease [41], post-operative patients [4,42,43] and in heart failure [44]. If such a score could be designed and validated in the CCD population, it could be immensely helpful in identifying the patients that are most at risk for deterioration, so that more aggressive medical and supportive therapy could be targeted towards them.…”

Section: Discussionmentioning

confidence: 99%

Translation of the Frailty Paradigm from Older Adults to Children with Cardiac Disease

et al. 2020

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Children and adolescents with cardiac disease (CCD) have significant morbidity and lower quality of life. However, there are no broadly applicable tools similar to the frailty score as described in the elderly, to define functional phenotype in terms of physical capability and psychosocial wellbeing in CCD. The purpose of this study is to investigate the domains of the frailty in CCD. We prospectively recruited CCD (8-17.5 years old, 70% single ventricle, 27% heart failure, 12% pulmonary hypertension; NYHA classes I, II and III) and age and gender matched healthy controls (total n = 56; CCD n = 34, controls n = 22; age 12.6 ± 2.6 years; 39.3% female). We measured the five domains of frailty: slowness, weakness, exhaustion, body composition and physical activity using developmentally appropriate methods. Age and gender-based population norms were used to obtain Z scores and percentiles for each measurement. Two-tailed t-tests were used to compare the two groups. The CCD group performed significantly worse in all five domains of frailty compared to healthy controls. Slowness: 6-min walk test with Z score −3.

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Modified Frailty Index Is an Effective Risk Assessment Tool in Primary Total Knee Arthroplasty

Cited by 96 publications

References 23 publications

Frailty and functional outcomes after open and endovascular procedures for patients with peripheral arterial disease: A systematic review

Frailty and functional outcomes after open and endovascular procedures for patients with peripheral arterial disease: A systematic review

<p>Frailty and Post-Operative Outcomes in the Older Patients Undergoing Elective Posterior Thoracolumbar Fusion Surgery</p>

Translation of the Frailty Paradigm from Older Adults to Children with Cardiac Disease

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