Predictors of Clavien 4 Complications and Mortality After Necrosectomy: Analysis of the NSQIP Database

Kolbe, Nina; Bakey, Stephanie; Louwers, Lisa; Blyden, Dionne; Horst, Mathilda; Falvo, Anthony; Patton, Joe H.; Rubinfeld, Ilan

doi:10.1007/s11605-015-2815-2

Cited by 6 publications

(11 citation statements)

References 22 publications

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“…We found when comparing the modified frailty index score to the CCI directly, only the modified frailty index score was associated with increasing Clavien‐Dindo classification IV complication rates in patients who underwent flap reconstructions. This validates the growing body of literature showing frailty is a better measure of physiologic reserve and the ability to withstand major operations over measures solely limited to comorbidities …”

Section: Discussionsupporting

confidence: 82%

“…Among the surgical literature, frailty has been shown to accurately predict severe postoperative complications. 2,[8][9][10][11][12][13][14] Adams et al 15 studied…”

Section: Discussionmentioning

confidence: 99%

“…Among the surgical literature, frailty has been shown to accurately predict severe postoperative complications . Adams et al studied whether the modified frailty index score could predict severe complications and mortality in otolaryngology.…”

Section: Discussionmentioning

confidence: 99%

“…6 The study included a 70item scale to measure a broad array of comorbidities, symptoms, and disabilities. The modified frailty index is a derivative of the CSHA, 7 which has been validated in numerous surgical fields, 2,[8][9][10][11][12][13][14] including head and neck surgery. 15,16 The modified frailty index has been shown to be a predictor of severe complications and mortality in head and neck surgery; however, it is unclear how reconstruction affects these complications.…”

Section: Introductionmentioning

confidence: 99%

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Frailty index: Intensive care unit complications in head and neck oncologic regional and free flap reconstruction

et al. 2017

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Section: Discussionsupporting

confidence: 82%

“…Among the surgical literature, frailty has been shown to accurately predict severe postoperative complications. 2,[8][9][10][11][12][13][14] Adams et al 15 studied…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frailty index: Intensive care unit complications in head and neck oncologic regional and free flap reconstruction

et al. 2017

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“…Our results are analogous to existing studies of mFI for other operations like hepatectomies, pancreatectomies, necrosectomies and gynecologic operations. The mFI score is a highly useful tool for daily clinical use (14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Modified frailty index predicts complications and death after non-bariatric gastrectomies

Zorbas¹,

Velanovich²,

Esnaola³

et al. 2021

Transl Gastroenterol Hepatol

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Background: The modified frailty index (mFI) has been shown to predict mortality and morbidity after major operations. The aim of the present study was to assess the mFI as a preoperative predictor of shortterm postoperative complications and 30-day mortality in patients undergoing gastrectomy for non-bariatric diseases.Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried for patients who underwent total or partial gastrectomy from 2005 to 2011. A mFI was calculated based on 11 variables as previously described. The population divided into the following four categories based on the mFI score: the non-frail (mFI 0), the low frail (mFI 1), the intermediate frail (mFI 2) and frail (mFI ≥3). Thirty-day mortality and postoperative complications were evaluated.Results: Overall, 5,711 patients underwent a gastrectomy for non-bariatric diseases. Higher mFI score was associated with higher rates of mortality (from 1.2% in the non-frail group to 10.7% in frail group, P<0.001), overall morbidity (26.7% vs. 51.1%, P<0.001), postoperative Clavien IV complication (6% vs. 24.6%, P<0.001), serious complications (19.3% vs. 42.6%, P<0.001), sepsis-related complications (8.4% vs. 16.4%, P<0.001), cardiopulmonary complications (5% vs. 20.7%, P<0.001) and failure to rescue (5.7% vs. 21.8%, P<0.001).Conclusions: Higher mFI score in patients undergoing non-bariatric gastrectomy, is associated with a stepwise greater risk of postoperative morbidity and mortality. MFI Score can be easily calculated preoperatively, from the patient's history, and it can be used as an exceptionally useful criterion for treatment planning.

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Assessment of the Predictive Value of the Modified Frailty Index for Clavien-Dindo Grade IV Critical Care Complications in Major Head and Neck Cancer Operations

Abt

Richmon

Koch

et al. 2016

JAMA Otolaryngol Head Neck Surg

105

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Predictors of Clavien 4 Complications and Mortality After Necrosectomy: Analysis of the NSQIP Database

Cited by 6 publications

References 22 publications

Frailty index: Intensive care unit complications in head and neck oncologic regional and free flap reconstruction

Frailty index: Intensive care unit complications in head and neck oncologic regional and free flap reconstruction

Modified frailty index predicts complications and death after non-bariatric gastrectomies

Assessment of the Predictive Value of the Modified Frailty Index for Clavien-Dindo Grade IV Critical Care Complications in Major Head and Neck Cancer Operations

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