Predictive value of modified frailty index-5 to major complications after videothoracoscopic pulmonary resections

Although minimally invasive methods have become widespread, pulmonary resections due to lung cancer continue to be an important cause of postoperative morbidity. Herein, we have investigated the predicting efficacy of modified frailty index-5 (MFI-5) for postoperative complications in patients who underwent pulmonary resection by VATS for non-small cell lung cancer (NSCLC). We retrospectively reviewed the data of patients who underwent VATS lobectomy/segmentectomy for NSCLC. MFI-5 score was calculated according to hypertension, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and functional independence status. Major postoperative complications were determined based on Clavien-Dindo classification. The predictive efficacy of MFI-5 score for major complications was tested by univariate and multivariate logistic regression analysis. A total of 336 patients were included in the study. The mean age was 65.6 ± 9.8 years. MFI-5 score was zero in 126 (37.5%) patients and positive in 210 patients. The major complication rate was 25.9%. Multivariate analysis showed that 2 and higher MFI-5 score significantly predicted the presence of postoperative major complications (p: 0.004, OR: 4.3, 1.58-12.5 95% CI). The MFI-5 score can significantly predict the presence of major postoperative complications, including 30-day mortality, in patients undergoing VATS pulmonary resection for NSCLC. Clinical registration 2024-324, approved by Gazi University Local Ethics Committee.