The 5-Item Modified Frailty Index Is Predictive of 30-Day Postoperative Complications in Patients Undergoing Kyphoplasty Vertebral Augmentation

Segal, Dale N; Wilson, Jacob M.; Staley, Christopher; Michael, Keith W.

doi:10.1016/j.wneu.2018.04.172

Cited by 93 publications

(65 citation statements)

References 24 publications

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“… 4 , 5 A threshold mFI-5 score of ≥2 was used based on the precedent set in previous studies assessing the predictive value of the mFI-5 for morbidity and mortality in various surgical subspecialties. 14 , 16 , 17 , 19 , 23 In this study, patients with increased frailty were shown to have significantly higher rates of both wound and overall complications, as well as increased hospital LOS within 30 days following panniculectomy. This corresponds with the fact that several components of the mFI-5 are known individual risk factors for complications following abdominoplasty.…”

Section: Discussionmentioning

confidence: 63%

“…The mFI-5 has been shown to be an independent predictor of postoperative complications in several surgical specialties, 11 as well as a multitude of individual surgical procedures. 13 , 14 , 17 – 23 The 5-item mFI is more practical to calculate as opposed to the 11-item mFI and the original 70-item index. 24 , 25 Despite the decrease in input variables, the mFI-5 has been validated to correlate with the 11-item index as an independent predictor of postoperative complications in several surgical specialties.…”

Section: Discussionmentioning

confidence: 99%

“…Each of these factors accounts for 1 point, and the minimum value for the mFI-5 is 0, while the maximum value is 5. mFI-5 score was analyzed as a binary categorical variable to compare groups with a low mFI-5 score of <2 with those with a high mFI-5 score of ≥2. 11 , 13 , 14 Patient preoperative demographics, clinical factors, and medical comorbidities at the time of surgery were analyzed. Primary outcomes of the study included wound complication and overall complication.…”

Section: Methodsmentioning

confidence: 99%

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Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Lee

Alfonso

Kantar

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Due to the high complication rate of panniculectomies, preoperative risk stratification is imperative. This study aimed to assess the predictive value of the 5-item modified frailty index (mFI-5) for postoperative complications in the elderly following panniculectomy. Methods: A retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program database for patients over the age of 65 years who underwent a panniculectomy between 2010 and 2015 was conducted. The mFI-5 score was calculated for each patient based on the presence of diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dependent functional status, and an mFI-5 score of 2 was used as a cutoff. Multivariate logistic and linear regression analysis was used to determine the validity of the mFI-5 as a predictor of postoperative complications. Results: A total of 575 patients were analyzed. Patients with an mFI-5 score of 2 or more (421; 73.2%) had significantly higher rates of wound complications (19.5% versus 12.8%; P = 0.03), overall complications (33.8% versus 19.5%; P < 0.001), and significantly longer hospital length of stay (3.6±5.0 versus 1.9±3.0; P < 0.001). mFI-5 score of 2 or more was an independent risk factor for wound complications (odds ratio, 1.26; 95% confidence interval, 1.08–2.20; P = 0.04) and overall complications (odds ratio, 1.34; 95% confidence interval, 1.09–2.15; P = 0.02). Conclusions: Frailty, as measured by the mFI-5, holds a predictive value regarding outcomes of wound complications and overall complications in elderly patients after panniculectomy. The mFI-5 score can be used to identify high-risk patients before surgery.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Lee

Alfonso

Kantar

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Overall frailty, as defined by multiple comorbidities, has been linked to postoperative complications among other kinds of orthopedic surgeries. 33,38 To our knowledge, no study has previously assessed the relationship between a summative comorbidity burden or frailty and outcomes following hammertoe surgery. Nevertheless, our finding that the presence of multiple comorbidities is associated with increased rates of superficial wound development and recurrence requiring surgery agrees with the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

“…Although complications following hammertoe correction surgery are rare, older patients with comorbid conditions are often considered more frail and therefore at an increased risk for adverse outcomes. 11,33,37,38 The aim of this study was to determine if the presence of multiple comorbidities was associated with increased complications or unsuccessful patient-reported outcomes following operative hammertoe correction in geriatric patients.…”

Section: Introductionmentioning

confidence: 99%

Comorbidities Associated With Poor Outcomes Following Operative Hammertoe Correction in a Geriatric Population

Maidman

Erwood

Manz

et al. 2020

Foot & Ankle Orthopaedics

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Background: Although complications following hammertoe correction surgery are rare, older patients with comorbid conditions are often considered poorer operative candidates compared with younger, healthier patients because of a suspected increased risk of adverse outcomes. The aim of this study was to determine if the presence of multiple comorbidities was associated with increased complications or unsuccessful patient-reported outcomes following operative hammertoe correction in geriatric patients. Methods: Prospectively collected data was reviewed on 78 patients aged 60 years or older who underwent operative correction of hammertoe deformity. Patient demographics, comorbidities, and postoperative complications were recorded. Patient-reported outcomes were assessed using preoperative and postoperative visual analog scale for pain and Short Form Health Survey Physical and Mental Component Summary with 1 year of follow-up. Patients were divided into 2 groups based on number of comorbidities (0 or 1 vs > 2) and then compared. The average age of patients was 69.4 years and the prevalence of comorbidities in the study population was as follows: 11.5% smokers, 25.6% on blood thinners, 15.4% with rheumatoid arthritis, 7.7% with diabetes mellitus, 2.6% with peripheral arterial disease, 6.4% with chronic obstructive pulmonary disease, 11.5% with coronary artery disease, and 23.1% with osteoporosis. Results: Fifty-three patients (67.9%) had 0 or 1 comorbidity and 25 (32.1%) had 2 or more comorbidities. Compared to the 0 or 1 comorbidity group, the presence of multiple comorbidities was associated with an adjusted odds ratio (OR) for superficial wound infection of 4.18 ( P = .045) and deformity recurrence requiring surgery OR of 23.15 ( P = .032). Patient-reported outcomes were similar between comorbidity groups. Conclusions: This study further informs foot and ankle specialists to maintain increased surveillance for postoperative complications and unsuccessful outcomes in patients with multiple comorbidities. Although geriatric patients still report significant improvements in both pain and function, patients with underlying medical conditions should be counseled about their increased risks when pursuing operative hammertoe correction. Level of Evidence: Level III, retrospective comparative series.

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Evaluation of modified frailty index for predicting post‐operative outcomes after lower‐extremity free‐flap reconstruction

et al. 2023

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BackgroundRisk stratification for complex procedures such as microsurgical reconstruction of the lower extremities is an important part of preoperative planning and counseling. The aim of this study was to determine the effectiveness of the modified five‐item frailty index (5‐mFI) score, a validated tool for assessing risk in surgical patients, in predicting postoperative complications after lower extremity (LE) free flap reconstruction.MethodsA retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) database was conducted from 2010 to 2020 on patients who underwent LE free‐flap reconstruction. 5‐mFI scores were calculated and patients were categorized as 5‐mFI ≥2 or <2.The primary endpoint was the presence of 30‐day overall complications. The secondary endpoints included 30‐day readmission, need for reoperation, and need to discharge to a care facility. Comparisons were made using one‐way analysis of variances, Pearson's chi‐squared test, or Fisher's extract test. Multivariable logistic regression models were performed for sex, age, BMI, smoker status, operative time, and ASA classification.ResultsTotal of 294 (61.6% males) patients were identified. Univariate analysis showed 5‐mFI ≥2 had higher rates of overall complications (p = .043) and hematologic complications (p = .033). In this population, there were also higher rates of reoperation (p = .003) and discharge to care facility (p < .001). Multivariable regression models further substantiated that 5‐mFI ≥2 was independently associated with increased overall complications [2.46, CI: 1.10–5.59, p = .031], hematologic complications [2.55, 1.02–6.35, p = .046], reoperation [4.55, 1.54–13.3, p = .006], and discharge to facility [2.86, 1.27–6.45, p = .011].ConclusionsThere is a strong association of 5‐mFI ≥2 with adverse post‐operative outcomes in male patients undergoing LE free‐flap reconstruction. This can be a valuable adjunct in the counsel of patients for whom lower extremity salvage is feasible.

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The 5-Item Modified Frailty Index Is Predictive of 30-Day Postoperative Complications in Patients Undergoing Kyphoplasty Vertebral Augmentation

Cited by 93 publications

References 24 publications

Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Comorbidities Associated With Poor Outcomes Following Operative Hammertoe Correction in a Geriatric Population

Evaluation of modified frailty index for predicting post‐operative outcomes after lower‐extremity free‐flap reconstruction

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