Modified frailty index is an effective risk-stratification tool for patients undergoing total shoulder arthroplasty

Holzgrefe, Russell E.; Wilson, Jacob M.; Staley, Christopher; Anderson, Travis L.; Wagner, Eric R.; Gottschalk, Michael B.

doi:10.1016/j.jse.2018.12.004

Cited by 59 publications

(57 citation statements)

References 46 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: 61%

“…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%

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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: 61%

Section: Discussionmentioning

confidence: 99%

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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“…9 Several other studies have shown the mFI-5 to be a valid predictor of outcomes in patients undergoing various types of surgery. [10][11][12][13] However, to our knowledge, no study has validated the mFI-5 for use predicting outcomes in patients undergoing mastectomy. This could improve preoperative risk stratification, patient selection, and optimization prior to surgery, as has been seen in colorectal surgery.…”

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confidence: 99%

Predicting postoperative complications following mastectomy in the elderly: Evidence for the 5‐factor frailty index

et al. 2021

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Breast cancer remains the most commonly diagnosed cancer in women in the United States. 1 Surgical options include breast conservation surgery or mastectomy, with similar survival rates. 2,3 Patients who undergo mastectomy can subsequently decide to pursue immediate or delayed breast reconstruction. Postoperative complications of these procedures remain a major concern and lead to significant morbidity, including surgical site infection, skin flap necrosis, loss of implant, and need for reoperation. Complications can result in prolonged hospital stays, increased costs, and the delay of adjuvant therapy. 4 It is important to identify risk factors for post-mastectomy complications to provide adequate counseling and mitigate risk.Several predictors of surgical outcomes have been analyzed, including body mass index (BMI), smoking status, age, and medical comorbidities. More recently, the concept of frailty was introduced as a surrogate for physiologic age, with the goal of developing a more accurate predictor. Frailty is defined as a generalized, aging-related clinical state in which there is a diminished physiological reserve and function and an increased vulnerability to stressors, including surgery. 5 Frailty has been shown to be strongly associated with adverse outcomes, including postoperative complications, mortality,

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“…For example, frailty screening using a modified frailty index for elective total shoulder arthroplasty showed that frailty was more predictive of postoperative complications, readmission, reoperation, and increased length of stay than age alone. 34) A cohort study of non-cardiac surgical patients used a novel operative stress score to quantify physiologic stress for surgical procedures. Using the Risk Analysis Index for frailty screening, the study found that frail patients had higher rates of complications and 30day mortality, which continually increased at 90 and 180 days regardless of physiological stress scores, where even low-to moderate-stress procedures such as cystoscopy were high-risk in frail patients.…”

Section: Frailty In Older Surgical Patientsmentioning

confidence: 99%

Section: Frailty In Older Surgical Patientsmentioning

confidence: 99%

Utility of Frailty Screening Tools in Older Surgical Patients

Poh

Teo

2020

Ann Geriatr Med Res

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tion. 4) An observational study showed a poor prognosis for functional recovery among older patients hospitalized for acute medical illness and discharged with a new or additional disability. Identifying these patients early enables clinicians to provide intensive rehabilitation interventions, caregiver support, or consideration of palliative care. 5) For example, before surgical intervention, identifying frailty may facilitate early rehabilitation to improve the likelihood of recovery. It may also be appropriate to counsel frail patients against surgery or offer palliation if there is a high risk of complications, including dependence and mortality. This paper provides an overview of frailty and frailty screening tools and suggests an approach that incorporates a frailty scale in preoperative assessments for older surgical patients to identify those who may benefit from early intervention and rehabilitation. FRAILTY The Asia-Pacific Clinical Practice Guideline indicates that frailty can be identified through three approaches, namely the Fried

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Modified frailty index is an effective risk-stratification tool for patients undergoing total shoulder arthroplasty

Cited by 59 publications

References 46 publications

Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

Predicting postoperative complications following mastectomy in the elderly: Evidence for the 5‐factor frailty index

Utility of Frailty Screening Tools in Older Surgical Patients

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