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Reliability of the modified Frailty Index (mFI) for intervention and continued surveillance in elective infrarenal

Mary J Connolly1, Abubakr Ahmed1, Amy Worrall2

  • 1Department of Vascular Surgery, St. Vincent's Hospital, Dublin, Ireland.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|December 1, 2022
PubMed
Abstract

Insights

The modified Frailty Index (mFI) effectively predicts surgical outcomes for abdominal aortic aneurysm (AAA) patients. Higher mFI scores correlate with clinicians

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Surgical Outcomes Research

Background:

  • Frailty significantly increases morbidity and mortality in surgical patients, irrespective of age.
  • The modified Frailty Index (mFI) is a validated tool for assessing patient frailty.
  • Understanding frailty's impact is crucial for optimizing surgical decision-making.

Purpose of the Study:

  • To evaluate the correlation between the modified Frailty Index (mFI) and clinical decisions regarding abdominal aortic aneurysm (AAA) surgery.
  • To determine if mFI aligns with experienced clinicians' judgments on patient suitability for AAA intervention and surveillance.

Main Methods:

  • Retrospective review of a database of abdominal aortic aneurysm (AAA) patients treated in 2017.
  • Categorization of patients based on treatment decisions: surveillance, declined surveillance, offered surgery, turned down for surgery, or declined surgery.
  • Analysis of modified Frailty Index (mFI) scores within each patient category.

Main Results:

  • Patients turned down for surveillance (<5.5 cm) had a significantly higher mFI (0.27) compared to those continuing surveillance (0.09, p < 0.0001).
  • Patients turned down for surgical intervention (>5.5 cm) had a higher median mFI (0.36) than those offered surgery (0.09, p < 0.0001).
  • The mFI demonstrated a statistically significant correlation with clinical decisions for both AAA surveillance and surgical intervention.

Conclusions:

  • Frailty, as measured by the mFI, is strongly associated with adverse outcomes in abdominal aortic aneurysm (AAA) patient cohorts.
  • The modified Frailty Index (mFI) is a reliable and practical tool for predicting perioperative results in AAA interventions.
  • mFI scores align with experienced clinicians' decisions regarding patient selection for AAA surgery and ongoing surveillance.
Keywords:
Abdominal aortic aneurysmFrailty indexOutcomesSurveillance

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