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Updated: Jun 7, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Higher modified frailty index score is associated with 30-day postoperative complications following revision total
Bruce Tanner Seibold1, Theodore Quan1, Amy Y Zhao1
1Department of Orthopaedic Surgery, The George Washington University, Washington, DC, USA.
Background:
Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).
Methods:
Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications.
Results:
Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84).
Discussion:
The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
Insights
The 5-item modified frailty index (mFI-5) helps predict poor outcomes in revision total shoulder arthroplasty (TSA) patients. Higher mFI-5 scores correlate with increased risks of complications like readmission and extended hospital stays.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Health Services Research
Background:
- Increased 5-item modified frailty index (mFI-5) scores are linked to adverse surgical outcomes.
- The specific comorbidities within the mFI-5 require investigation for their association with outcomes in revision total shoulder arthroplasty (TSA).
Purpose of the Study:
- To determine if comorbidities included in the mFI-5 correlate with poor outcomes after revision TSA.
- To assess the utility of the mFI-5 in stratifying patient risk for postoperative complications in this specific surgical population.
Main Methods:
- Utilized the National Surgical Quality Improvement Program (NSQIP) database.
- Calculated mFI-5 scores for patients aged 50+ undergoing revision TSA (2013-2019).
- Employed Pearson's Chi-squared tests and multivariable regression to analyze associations between mFI-5 scores and postoperative complications.
Main Results:
- Patients with mFI-5 scores of 2+ faced significantly higher risks of readmission (OR 2.58), transfusion-requiring bleeding (OR 3.66), prolonged length of stay (OR 2.43), and non-home discharge (OR 3.22) compared to those with scores of 0.
- Compared to patients with an mFI-5 score of 1, those with scores of 2+ showed increased risks for postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and non-home discharge (OR 2.84).
Conclusions:
- The mFI-5 serves as a valuable tool for risk stratification in patients undergoing revision TSA.
- Higher mFI-5 scores are significantly associated with increased postoperative complications following revision shoulder arthroplasty.
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