New 5-Factor Modified Frailty Index Using American College of Surgeons NSQIP Data

2018 ◽  
Vol 226 (2) ◽  
pp. 173-181.e8 ◽  
Author(s):  
Sneha Subramaniam ◽  
Jeffrey J. Aalberg ◽  
Rainier P. Soriano ◽  
Celia M. Divino
Keyword(s):  
Frailty Index ◽  
American College Of Surgeons ◽  
Modified Frailty Index

scholarly journals The Impact of Frailty on Morbidity and Mortality following Open Emergent Colectomies

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Dominick V. Congiusta ◽  
Prashanth Palvannan ◽  
Aziz M. Merchant
Keyword(s):  
Care Setting ◽  
Frailty Index ◽  
Acute Care Setting ◽  
Improvement Program ◽  
Mortality And Morbidity ◽  
National Quality ◽  
American College Of Surgeons ◽  
Modified Frailty Index ◽  
The Impact ◽  
The Relationship

Background. Elderly and frail patients undergo open emergency colectomies and are at greater risk for complications. The relationship between frailty and open emergent colectomies is yet unexplored.Objective. The purpose of this study was to evaluate the relationship between frailty and outcomes after open emergent colorectal surgery.Design. Using the American College of Surgeons National Quality Improvement Program database, a validated modified frailty index was used, along with logistic regression, to assess the relationship between frailty and outcomes.Main Outcome Measures. Outcomes included mortality (primary), Clavien-Dindo Complication Grade >3, reintubation, ventilator >48 hours, and reoperation (secondary).Results. The rates for 30-day mortality, Clavien-Dindo Grade >3, reintubation, ventilator > 48 hours, and reoperation in our cohort were 16.6%, 36.9%, 8.6%, 23.9%, and 15.0%, respectively. There was a statistically significant increase in prevalence of all outcomes with increasing frailty.Limitations. A causal relationship between frailty and complications cannot be established in a retrospective analysis. Also, extrapolation of our data to reflect outcomes beyond 30 days must be done with caution.Conclusions. Frailty is a statistically significant predictor of mortality and morbidity after open emergent colectomies and can be used in an acute care setting.

scholarly journals P.221 Frailty is an Important Predictor of 30-day Morbidity in Patients Treated for Lumbar Spondylolisthesis Using a Posterior Surgical Approach

2021 ◽  
Vol 48 (s3) ◽  
pp. S83-S84
Author(s):  
V Chan ◽  
C Witiw ◽  
J Wilson ◽  
MG Fehlings
Keyword(s):  
Frailty Index ◽  
Major Complication ◽  
Unplanned Readmission ◽  
Improvement Program ◽  
Posterior Surgery ◽  
Increased Risk ◽  
Degenerative Lumbar Spondylolisthesis ◽  
American College Of Surgeons ◽  
Modified Frailty Index ◽  
Lumbar Spondylolisthesis

Background: A non-operative approach has been favoured for elderly patients with lumbar spondylolisthesis due to a perceived higher risk with surgery. However, most studies have used an arbitrary age cut-off to define “elderly.” We hypothesized that frailty is an independent predictor of morbidity after surgery for lumbar spondylolisthesis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database for years 2010 to 2018 was used. Patients who received posterior lumbar spine decompression with or without posterior fusion instrumented fusion for degenerative lumbar spondylolisthesis were included. The primary outcome was major complication. Secondary outcomes were readmission, reoperation, and discharge to location other than home. Logistic regression analysis was done to investigate the association between outcomes and frailty. Results: There were 15 658 patients in this study. The mean age was 62.5 years (SD 12.2). Frailty, as measured by the Modified Frailty Index-5 was significantly associated with increased risk of major complication, unplanned readmission, reoperation, and non-home discharge. Increasing frailty was associated with increasing risk of morbidity. Conclusions: Frailty is independently associated with higher risk of morbidity after posterior surgery in patients with lumbar spondylolisthesis. These data are of significance to clinicians in planning treatment for these patients.

scholarly journals Frailty predicts outcome of partial nephrectomy and guides treatment decision towards active surveillance and tumor ablation

2021 ◽  
Author(s):  
M. T. Walach ◽  
M. F. Wunderle ◽  
N. Haertel ◽  
J. K. Mühlbauer ◽  
K. F. Kowalewski ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Surgical Outcome ◽  
Frailty Index ◽  
Treatment Decision ◽  
Solitary Kidney ◽  
Tumor Ablation ◽  
Renal Masses ◽  
Skeletal Muscle Index ◽  
Decision Tools ◽  
Modified Frailty Index

Abstract Purpose To examine frailty and comorbidity as predictors of outcome of nephron sparing surgery (NSS) and as decision tools for identifying candidates for active surveillance (AS) or tumor ablation (TA). Methods Frailty and comorbidity were assessed using the modified frailty index of the Canadian Study of Health and Aging (11-CSHA) and the age-adjusted Charlson-Comorbidity Index (aaCCI) as well as albumin and the radiological skeletal-muscle-index (SMI) in a cohort of n = 447 patients with localized renal masses. Renal tumor anatomy was classified according to the RENAL nephrometry system. Regression analyses were performed to assess predictors of surgical outcome of patients undergoing NSS as well as to identify possible influencing factors of patients undergoing alternative therapies (AS/TA). Results Overall 409 patient underwent NSS while 38 received AS or TA. Patients undergoing TA/AS were more likely to be frail or comorbid compared to patients undergoing NSS (aaCCI: p < 0.001, 11-CSHA: p < 0.001). Gender and tumor complexity did not vary between patients of different treatment approach. 11-CSHA and aaCCI were identified as independent predictors of major postoperative complications (11-CSHA ≥ 0.27: OR = 3.6, p = 0.001) and hospital re-admission (aaCCI ≥ 6: OR = 4.93, p = 0.003) in the NSS cohort. No impact was found for albumin levels and SMI. An aaCCI > 6 and/or 11-CSHA ≥ 0.27 (OR = 9.19, p < 0.001), a solitary kidney (OR = 5.43, p = 0.005) and hypoalbuminemia (OR = 4.6, p = 0.009), but not tumor complexity, were decisive factors to undergo AS or TA rather than NSS. Conclusion In patients with localized renal masses, frailty and comorbidity indices can be useful to predict surgical outcome and support decision-making towards AS or TA.

The modified frailty index-11 predicts medium-term outcomes after endovascular revascularisation for chronic limb threatening ischaemia in Asian patients

Vascular ◽  
2021 ◽  
pp. 170853812098822
Author(s):  
Shereen XY Soon ◽  
Reuban D’Çruz ◽  
Charyl JQ Yap ◽  
Wei Ling Tay ◽  
Siew Ping Chng ◽  
...  
Keyword(s):  
Complication Rate ◽  
Early Recognition ◽  
Frailty Index ◽  
Arterial Disease ◽  
Unplanned Readmission ◽  
Medium Term ◽  
Post Intervention ◽  
Asian Patients ◽  
Modified Frailty Index ◽  
The Mean

Objective The aim was to evaluate the utility of frailty, as defined by the modified Frailty Index-1 1 (mFI-11) on predicting outcomes following endovascular revascularisation in Asian patients with chronic limb-threatening ischaemia (CLTI). Methods CLTI patients who underwent endovascular revascularisation between January 2015 and March 2017 were included. Patients were retrospectively scored using the mFI-11 to categorise frailty as low, medium or high risk. Observed outcomes included 30-day complication rate and unplanned readmissions, 1-, 6- and 12-month mortality, and ambulation status at 6- and 12 months post-intervention. Results A total of 233 patients (250 procedures) were included; 137 (58.8%) were males and the mean age was 69.0 (±10.7) years. 202/233 (86.7%) were diabetic and 196/233 (84.1%) had a prior diagnosis of peripheral arterial disease (PAD). The mean mFI-11 score was 4.2 (±1.5). 28/233 (12.0%), 155/233 (66.5%), and 50/233 (21.5%) patients were deemed low (mF-11 score 0–2), moderate (mFI-11 score 3–5) and high (mFI-11 score 5–7) frailty risk, respectively. High frailty was associated with an increased 12-month mortality (OR 8.54, 95% CI 1.05–69.5; p = 0.05), 30-day complication rate (OR 9.41, 95% CI 2.01–44.1; p < 0.01) and 30-day unplanned readmission (OR 5.06, 95% CI 1.06–24.2; p = 0.04). Furthermore, a high score was associated with a significantly worse 6- (OR 0.320, 95% CI 0.120–0.840; p = 0.02) and 12-month (OR 0.270, 95% CI 0.100–0.710; p < 0.01) ambulatory status. Conclusion The mFI-11 is a useful, non-invasive tool that can be readily calculated using readily available patient data, for prediction of medium-term outcomes for Asian CLTI patients following endovascular revascularisation. Early recognition of short- and mid-term loss of ambulation status amongst high-frailty patients in this challenging cohort of patients could aid decision-making for whether a revascularisation or amputation-first policy is appropriate, and manage patient and caregiver expectations on potential improvement in functional outcome.

scholarly journals RR27. Validation of a Modified Frailty Index to Predict Mortality in Vascular Surgery Patients

2015 ◽  
Vol 61 (6) ◽  
pp. 202S
Author(s):  
Bryan A. Ehlert ◽  
Alireza Najafian ◽  
Kristine C. Orion ◽  
Mahmoud B. Malas ◽  
James H. Black ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Frailty Index ◽  
Modified Frailty Index

Modified frailty index predicts postoperative outcomes of spontaneous intracerebral hemorrhage

2018 ◽  
Vol 175 ◽  
pp. 137-143 ◽  
Author(s):  
Yukihiro Imaoka ◽  
Takayuki Kawano ◽  
Akihito Hashiguchi ◽  
Kenji Fujimoto ◽  
Keizou Yamamoto ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Frailty Index ◽  
Postoperative Outcomes ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Modified Frailty Index
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