Related Experiment Video
Updated: Jul 2, 2025
Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
Modified frailty index (mFI): is it a predictor for early postoperative complications in arthroplasty surgery?
L Alıbaylı1, K S Cakar Turhan, V Baytas
1Department of Anesthesiology and ICU, Ufuk University Medical School, Ankara, Turkey. serkoc@ankara.edu.tr.
Objective:
It has been demonstrated that the modified frailty index (mFI) is a powerful and effective tool in the prediction of perioperative risk in many surgical fields. In many previous studies, mFI has been found to be successful in prediction of perioperative adverse effects. The aim of this study was to determine whether the mFI can be a predictor for early postoperative complications in arthroplasty surgery.
Patients And Methods:
145 patients aged 45-85 undergoing primary or revision total knee and hip arthroplasty were included in this prospective study. mFI was calculated in all patients, and patients included in the current study were grouped as "Frail" (n=42) and "Nonfrail" (n=103) patients according to modified frailty index values. Postoperative complications (myocardial infarction, cardiac arrest, pulmonary embolism, septic shock, postoperative dialysis requirement, cerebrovascular event, reintubation, prolonged mechanical ventilation, surgical wound complications), duration of hospitalization, requirement for intensive care unit (ICU) admission and rehospitalization and 30-day mortality were recorded and the correlation between mFI and these parameters were evaluated.
Results:
The mean age was 67.58±9.35 years, and 72.4% of the patients were female. The percentage of frail patients in the current study was 28.9%. The percentage of ASA-1, ASA-2, and ASA-3 patients was 17.2%, 57.2%, and 25.5%, respectively. The rate of ICU admission, MI, septic shock, postoperative dialysis requirement, prolonged MV requirement, hospital readmission, and 30-day mortality were 45.2%, 14.3%, 16.7%, 16.7%, 14.3%, 11.9%, and 16.7%, respectively in the frail group and were 7.8%, 1%, 1.9%, 2.9, 1.9% and 3.9%, respectively in the nonfrail group. Advanced age, male gender, high ASA score and prolonged duration of surgery were found to be predictive factors for postoperative complications. Advanced age, high ASA score and prolonged duration of surgery were found to be predictive factors for ICU admission. Advanced age, male gender and high ASA score were found to be strong predictors of 30-day mortality.
Conclusions:
mFI was found to be a strong predictor for postoperative complications and mortality. It is an easy, reliable, and simple method to evaluate frailty during the preoperative period.
Clinical Trial Registration Number:
NCT05424575.
Insights
The modified frailty index (mFI) effectively predicts early postoperative complications and mortality in arthroplasty patients. This simple preoperative assessment tool enhances patient risk evaluation for better surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Perioperative Medicine
Background:
- The modified frailty index (mFI) is recognized for predicting perioperative risk across various surgical specialties.
- Previous studies have established the mFI's efficacy in forecasting adverse perioperative events.
- Clinical Trial Registration: NCT05424575.
Purpose of the Study:
- To evaluate the modified frailty index (mFI) as a predictor of early postoperative complications specifically in arthroplasty surgery.
- To assess the correlation between mFI and key postoperative outcomes, including complications, hospitalization duration, ICU admission, and 30-day mortality.
Main Methods:
- A prospective study included 145 patients (aged 45-85) undergoing primary or revision total knee and hip arthroplasty.
- Patients were categorized as "Frail" (n=42) or "Nonfrail" (n=103) based on their calculated mFI.
- Recorded outcomes included specific postoperative complications, ICU admission, rehospitalization, and 30-day mortality.
Main Results:
- Frail patients exhibited significantly higher rates of ICU admission (45.2% vs. 7.8%), myocardial infarction (14.3% vs. 1%), septic shock (16.7% vs. 1.9%), and 30-day mortality (16.7% vs. 3.9%).
- Advanced age, male gender, high ASA score, and prolonged surgery duration were identified as predictors for postoperative complications and ICU admission.
- Advanced age, male gender, and high ASA score strongly predicted 30-day mortality.
Conclusions:
- The modified frailty index (mFI) serves as a robust predictor of postoperative complications and mortality in arthroplasty patients.
- mFI is a straightforward, reliable, and easily implementable method for preoperative frailty assessment.
- Utilizing mFI can aid in optimizing preoperative patient management and potentially reduce adverse outcomes.
More Related Videos
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
06:58Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017