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Efficacy of the Modified 5-Item Frailty Index in Predicting Surgical-Site Infections in Patients Undergoing Breast
Background:
The ability to predict breast implant augmentation complications can significantly inform patient management. A frailty measure, such as the modified 5-item frailty index (mFI-5), is becoming an increasingly established risk factor for adverse postoperative outcomes. The authors hypothesized that the mFI-5 is predictive of 30-day postoperative complications in breast augmentation.
Objectives:
To investigate if mFI-5 can predict the likelihood and magnitude of 30-day complications resulting from breast augmentations.
Methods:
A retrospective review study of the National Surgical Quality Improvement Program database for patients who underwent breast implant augmentation without other concurrent procedures, from 2015 to 2019. Age, BMI, number of major comorbidities, American Society of Anesthesiologists (ASA) classifications, smoking status, mFI-5 score, and modified Charlson comorbidity index score were compared as predictors of all-cause 30-day complications and 30-day surgical-site complications using regression analyses.
Results:
Overall, 2478 patients were analyzed, and among them, 53 patients developed complications (2.14%). mFI-5 score significantly predicted surgical-site infection (SSI) complications (odds ratio [OR] = 4.24, P = .026). Frail patients had a higher occurrence of SSIs than nonfrail patients (P = .049). Multivariable analyses showed ASA class predicted 30-day SSI complications (OR = 5.77, P = .027) and mFI-5 approached, but did not reach full significance in predicting overall 30-day complications (OR = 3.14, P = .085).
Conclusions:
To date, the impact of frailty on breast implant procedure outcomes has not been studied. Our analysis demonstrates that the mFI-5 is a significant predictor for SSIs in breast implant augmentation surgery and is associated with overall complications. By preoperatively identifying frail patients, the surgical team can better account for postoperative support to minimize the risk of complications.
Insights
The modified 5-item frailty index (mFI-5) significantly predicts surgical-site infections after breast augmentation. Identifying frail patients preoperatively can improve postoperative care and reduce complication risks.
Area of Science:
- Plastic Surgery
- Surgical Outcomes Research
- Geriatric Surgery
Background:
- Predicting complications after breast implant augmentation is crucial for patient management.
- Frailty, measured by the modified 5-item frailty index (mFI-5), is an emerging risk factor for adverse surgical outcomes.
- The study investigates the predictive value of mFI-5 for 30-day complications in breast augmentation.
Purpose of the Study:
- To determine if the mFI-5 can predict the likelihood and severity of 30-day postoperative complications following breast augmentation.
- To assess the association between frailty and specific complication types, such as surgical-site infections (SSIs).
Main Methods:
- Retrospective analysis of the National Surgical Quality Improvement Program database (2015-2019).
- Included patients who underwent breast implant augmentation without concurrent procedures.
- Compared mFI-5, age, BMI, comorbidities, ASA class, and smoking status as predictors of 30-day complications using regression analyses.
Main Results:
- 2,478 patients were analyzed; 53 (2.14%) experienced complications.
- mFI-5 significantly predicted surgical-site infections (SSI) (OR=4.24, P=.026).
- Frail patients had a higher incidence of SSIs (P=.049). ASA class also predicted SSI (OR=5.77, P=.027).
Conclusions:
- The modified 5-item frailty index (mFI-5) is a significant predictor of SSIs in breast augmentation.
- Preoperative identification of frail patients allows for enhanced postoperative support to minimize complication risks.
- Frailty assessment can improve patient selection and management strategies for breast augmentation procedures.
