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

2018 ◽  
Vol 116 ◽  
pp. e225-e231 ◽  
Author(s):  
Dale N. Segal ◽  
Jacob M. Wilson ◽  
Christopher Staley ◽  
Keith W. Michael
Keyword(s):  
Postoperative Complications ◽  
Frailty Index ◽  
Vertebral Augmentation ◽  
Modified Frailty Index

scholarly journals Association of a Modified Frailty Index with Postoperative Outcomes after Ankle Fractures in Patients Aged 50 Years and Older

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002 ◽  
Author(s):  
Rishin Kadakia ◽  
Jason Bariteau ◽  
Catphuong Vu ◽  
Andrew Pao ◽  
Shay Tenenbaum
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Assessment Tool ◽  
Frailty Index ◽  
Reoperation Rate ◽  
Ankle Fractures ◽  
Postoperative Outcomes ◽  
Improvement Project ◽  
Modified Frailty Index ◽  
Reoperation Rates

Category: Ankle, Trauma Introduction/Purpose: Frailty, a multifaceted syndrome resulting from a decrease in physiologic reserves, has been previously shown to play a significant role in elderly morbidity and mortality. The literature on frailty within orthopaedic surgery is limited currently. No study to date has assessed frailty as a predictor of postoperative outcomes in elderly patients with ankle fractures. We hypothesized that increasing frailty would be associated with increased 30-day reoperation rates and increased postoperative complications. Methods: The National Surgical Quality Improvement Project (NSQIP) was queried using the appropriate CPT codes to identify inpatients from 2005-2014 who were aged 50 years and older that sustained an ankle fracture and underwent operative fixation. Frailty was assessed using a modified frailty index (MFI), abbreviated with 11 variables from the Canadian Study of Health and Aging Frailty Index. The primary outcome was 30-day reoperation rate and secondary outcomes were postoperative surgical and medical complications, readmission rates, and length of stay. Bivariate and multivariate analysis was used to determine association between outcomes and MFI. Results: 6,749 patients were identified, and the mean age of these patients was 64.4 years. Patients with increased MFI scores had significantly higher rates of postoperative complications. In addition, increased MFI scores was also associated with increased 30 day readmissions and reoperations. Multivariate analysis also demonstrated that MFI was a stronger predictor of 30 day reoperation rates (odds ratio of 17.7, P < 0.001) than age, wound class, and ASA class. Conclusion: Frailty has the potential to be an important predictive variable of postoperative outcomes in patients aged 50 years and older who sustain ankle fractures. The modified frailty index can be a valuable preoperative risk assessment tool for the orthopaedic surgeon. Further study is necessary to examine the effect of the MFI in a larger prospective setting.

The 5-Item Modified Frailty Index is Predictive of 30-Day Postoperative Complications in Patients Undergoing Spine Surgery

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Katherine E. Pierce ◽  
Sara Naessig ◽  
Nicholas Kummer ◽  
Kylan Larsen ◽  
Waleed Ahmad ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Spine Surgery ◽  
Frailty Index ◽  
Modified Frailty Index

scholarly journals The composite risk index based on frailty predicts postoperative complications in older patients recovering from elective digestive tract surgery: a retrospective cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Chun-Qing Li ◽  
Chen Zhang ◽  
Fan Yu ◽  
Xue-Ying Li ◽  
Dong-Xin Wang
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Digestive Tract ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Risk Index ◽  
Frailty Index ◽  
Modified Frailty Index ◽  
Digestive Tract Surgery ◽  
Composite Risk

Abstract Background Limitations exist in available studies investigating effect of preoperative frailty on postoperative outcomes. This study was designed to analyze the association between composite risk index, an accumulation of preoperative frailty deficits, and the risk of postoperative complications in older patients recovering from elective digestive tract surgery. Methods This was a retrospective cohort study. Baseline and perioperative data of older patients (age ≥ 65 years) who underwent elective digestive tract surgery from January 1, 2017 to December 31, 2018 were collected. The severity of frailty was assessed with the composite risk index, a composite of frailty deficits including modified frailty index. The primary endpoint was the occurrence of postoperative complications during hospital stay. The association between the composite risk index and the risk of postoperative complications was assessed with a multivariable logistic regression model. Results A total of 923 patients were included. Of these, 27.8% (257) developed postoperative complications. Four frailty deficits, i.e., modified frailty index ≥0.27, malnutrition, hemoglobin < 90 g/L, and albumin ≤30 g/L, were combined to generate a composite risk index. Multivariable analysis showed that, when compared with patients with composite risk index of 0, the odds ratios (95% confidence intervals) were 2.408 (1.714–3.383, P <  0.001) for those with a composite risk index of 1, 3.235 (1.985–5.272, P <  0.001) for those with a composite risk index of 2, and 9.227 (3.568–23.86, P <  0.001) for those with composite risk index of 3 or above. The area under receiver-operator characteristic curve to predict postoperative complications was 0.653 (95% confidence interval 0.613–0.694, P <  0.001) for composite risk index compared with 0.622 (0.581–0.663, P <  0.001) for modified frailty index. Conclusion For older patients following elective digestive tract surgery, high preoperative composite risk index, a combination of frailty deficits, was independently associated with an increased risk of postoperative complications.

scholarly journals The Usefulness of the Modified Frailty Index for Muscle-Invasive Bladder Cancer Patients Treated with Radical Cystectomy

2020 ◽  
Vol 14 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Maarten J.H. Voskamp ◽  
Marloes Vermeer ◽  
Gerd-Jan Molijn ◽  
Erik B. Cornel
Keyword(s):  
Postoperative Complications ◽  
Confidence Interval ◽  
Radical Cystectomy ◽  
Treatment Options ◽  
Frailty Index ◽  
Multivariate Logistic Regression Analysis ◽  
Good Alternative ◽  
Chi Square ◽  
Modified Frailty Index ◽  
Muscle Invasive

Background: Radical cystectomy is still the gold standard for muscle-invasive bladder carcinoma (MIBC) treatment. In order to reduce postoperative complications, multimodality bladder-sparing therapies could be a good alternative. Studies in various malignancies have shown that the modified Frailty Index (mFI) may be more useful for identifying high-risk patients. Objectives: We investigated the possible correlation between the mFI in cystectomy patients with MIBC and serious complications 30 and 90 days postoperatively. Methods: Analysis of a prospective database of 109 consecutive MIBC patients who underwent a cystectomy between January 2012 and August 2017 was performed. The mFI was added retrospectively. Differences between groups were tested with independent t-tests, Mann-Whitney U tests, ANOVA, Kruskal-Wallis test, or Chi square tests as appropriate. Univariate and multivariate logistic regression analysis were performed to analyse the relation between the mFI and complications. Results: Patients with Clavien-Dindo ≥ 3 at 30 and 90 days postoperatively had a significantly higher mFI compared to patients with Clavien-Dindo < 3: the odds ratio of the mFI for serious complications within 30 days was 1.5 (95% confidence interval 1.1-2.1, p = 0.010) and for 90 days was 1.5 (95% confidence interval 1.1-2.1, p = 0.008). Conclusions: We found an association between a high mFI and postoperative complications and mortality. The mFI is therefore useful when discussing treatment options with MIBC patients.

scholarly journals Modified Frailty Index Predicts Postoperative Complications following Panniculectomy in the Elderly

2020 ◽  
Vol 8 (7) ◽  
pp. e2987
Author(s):  
Jasmine Lee ◽  
Allyson R. Alfonso ◽  
Rami S. Kantar ◽  
Gustave K. Diep ◽  
Zoe P. Berman ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Frailty Index ◽  
The Elderly ◽  
Modified Frailty Index

scholarly journals The association between preoperative modified frailty index and postoperative complications in Chinese elderly patients with hip fractures

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanjiao Shen ◽  
Qiukui Hao ◽  
Yuting Wang ◽  
Xiaoyan Chen ◽  
Jiaojiao Jiang ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Postoperative Complications ◽  
Hip Fractures ◽  
Medical Records ◽  
Older Patients ◽  
Frailty Index ◽  
Chinese Patients ◽  
Statistical Adjustment ◽  
Frail Patients ◽  
Modified Frailty Index

Abstract Objectives To investigate the role of a preoperative modified frailty index (mFI) based on data from medical records in predicting postoperative complications among older Chinese patients with hip fractures. Methods This retrospective cohort study included consecutive older patients with hip fracture admitted to the Department of Orthopaedics, West China Hospital, Sichuan University, from December 2010 to June 2017 who underwent surgical repair. We selected 33 variables, including characteristics of hip fracture, to construct a mFI. Each variable was coded with a value of 0 when a deficit was absent or 1 when it was present. We calculated the mFI as the proportion of positive items and defined frailty as mFI value greater than or equal to 0.21 according to threshold proposed by Hoover et al. We examined the relationship between mFI and severity of postoperative complications and the occurrence of in-hospital pneumonia including statistical adjustment for several demographics (e.g. age, gender, and marital status) and habits (smoking and alcohol intake), time from fracture to surgery in the multivariable model. Results We included 965 patients (34% male; mean age: 76.77 years; range: 60 to 100 years) with a prevalence of frailty of 13.06%. The presence of frailty was associated with a higher severity of complications (OR: 2.07; 95% CI: 1.40 to 3.05). Frail patients were more likely to develop in-hospital pneumonia than non-frail patients (OR: 2.08; 95% CI: 1.28 to 3.39). Conclusion The preoperative modified frailty index based on data from medical records proved significantly associated with postoperative complications among older patients with hip fractures undergoing hip surgery.

scholarly journals Frailty as a risk factor for postoperative complications in adult patients with degenerative scoliosis administered posterior single approach, long-segment corrective surgery: a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bin Li ◽  
Xianglong Meng ◽  
Xinuo Zhang ◽  
Yong Hai
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Posterior Approach ◽  
Frailty Index ◽  
Cardiac Complications ◽  
Corrective Surgery ◽  
Degenerative Scoliosis ◽  
Acute Renal Dysfunction ◽  
Radiographic Measurements ◽  
Single Approach

Abstract Background With the population aging worldwide, adult degenerative scoliosis (ADS) is receiving increased attention. Frailty, instead of chronological age, is used for assessing the patient’s overall physical condition. In ADS patients undergoing a posterior approach, long-segment corrective surgery, the association of frailty with the postsurgical outcomes remains undefined. Methods ADS patients who underwent a posterior approach, long-segment fusion at the Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University (CMU), Beijing, China, in 2014–2017 were divided into the frailty and non-frailty groups according to the modified frailty index. Major postoperative complications were recorded, including cardiac complications, pneumonia, acute renal dysfunction, delirium, stroke, neurological deficit, deep wound infection, gastrointestinal adverse events, and deep vein thrombosis. Radiographic measurements and health-related quality of life (HRQOL) parameters were recorded preoperatively and at 2 postoperative years. Results A total of 161 patients were included: 47 (29.2%) and 114 (70.8%) in the frailty and non-frailty groups, respectively. Major postoperative complications were more frequent in the frailty group than the non-frailty group (29.8% vs. 10.5%, P = 0.002). Multivariable logistic regression analysis showed that frailty was independently associated with major complications (adjusted odds ratio [aOR] = 2.77, 95% confidence interval [CI] 1.12–6.89, P = 0.028). Radiographic and HRQOL parameters were improved at 2 years but with no significant between-group differences. Conclusions Frailty is a risk factor for postoperative complications in ADS after posterior single approach, long-segment corrective surgery. Frailty screening should be applied preoperatively in all patients to optimize the surgical conditions in ADS.

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.

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